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[Prediction of Significant Coronary Lesions by SPECT Myocardial Perfusion. Results from a National Reference Hospital in Lima-Peru]

Overview
Journal Arch Peru Cardiol Cir Cardiovasc
Specialty Cardiology & Vascular Diseases
Date 2023 Jun 7
PMID 37283600
Authors
Luisa S Talledo-Paredes
Delia M T Guerrero-Ramirez
Aurelio Mendoza-Paulini
Zoila Rodriguez-Urteaga
Daniel Angulo-Poblete
Josias C Rios-Ortega
Affiliations
Soon will be listed here.
Abstract

Objective: To determine the discriminative capacity of myocardial perfusion with single photon emission tomography (SPECT) to predict coronary obstructions by coronary angiography. To determine mortality and major cardiovascular events at follow-up.

Materials And Methods: . Retrospective observational study with clinical follow-up in patients undergoing SPECT and then coronary angiography. We excluded patients with myocardial infarction and percutaneous and/or surgical revascularization in the previous 6 months.

Results: 105 cases were included in the study. The most commonly used SPECT protocol was pharmacological (70%). Patients with perfusion defect ≥10% of total ventricular mass (TVM) had significant coronary lesions (SCL) in 88% of cases (sensitivity 87.5% and specificity 83%). On the other hand, having ischemia ≥10% of the TVM was associated with 80% SCL (sensitivity: 72%, specificity: 65%). Clinical follow-up at 48 months evidenced that a perfusion defect ≥ 10% was predictive of major cardiovascular events (MACE) in both univariate (HR=5.3; 95%CI 1.2 - 22.2; p=0.022) and multivariate (HR= 6.1; 95%CI 1.3 - 26.9; p= 0.017) analyses.

Conclusions: . Having a perfusion defect ≥10% of the MVT in the SPECT study predicted with high probability and sensitivity the existence of SCL (>80%); moreover, this group had higher MACE at follow-up.

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