GW24-e2437 Prognostic value of 99mTcMIBI SPECT exercise myocardial imaging in patients with suspected or known coronary artery disease

Objectives To examine the prognostic value of 99mTC–MIBI SPECT in patients with suspected or known coronary artery disease. Methods The study group consisted of 116 patients with suspected or known CAD. All patients had been referred for 99mTC–MIBI SPECT exercise and rest myocardial imagings. The occurrence of cardiac events was followed up. Results Follow–up information was complete in 106 patients. Over an average follow–up of 25 ± 8 months, cardiac events occurred in 11 patients. Univariate analyses showed that age, old myocardial infarction, exercise peak heart rate, the change in heart rate from rest to exercise peak, exercise peak systolic blood pressure, the change in systolic blood pressure from rest to exercise peak, abnormal myocardial imaging, the number of myocardial perfusion defect and ischaemic volume rate were the effective predictor of subsepuent AMI or SCD. Multivariate stepwise Logistic regression analyses revealed that the size of ischaemic volume rate was the only variable with independent predictive value for occurrence of a subsequent cardiac event. Ischaemic volume rate more than 25% was associated with a significantly increased frequency of subsequent cardiac event (relative rive risk ratio was 5.9, P <0.005). Ischaemic volume rate less than 25% or even normal myocardial perfusion imaging was associated with a very low–risk of SCD or AMI and a very good prognosis. Conclusions In clinical real world, it is very important to correctly evaluate the risk of patients with suspected or knowned coronary artery disease. This study revealed that 99mTC-MIBI SPECT exercise myocardial imaging was the most effective predictive value for occurrence of a subsequent cardiac event. Ischaemic volume rate more than 25% was associated with a significantly increased frequency of subsequent cardiac event (relative rive risk ratio was 5.9, P < 0.005). Ischaemic volume rate less than 25% or even normal myocardial perfusion imaging was associated with a very low–risk of SCD or AMI and a very good prognosis. Therefore, high risk patients detected by 99mTC-MIBI SPECT exercise myocardial imaging should be performed with coronary artery angiography. These high risk patients can receive coronary revascularisation therapy. Low risk patients detected by 99mTC-MIBI SPECT exercise myocardial imaging have good prognosis and can receive medicine therapy. The use of this method Save the expenses of patients of suspected or knowned coronary artery disease.