Clinical Value Of Rest Gated Myocardial Perfusion SPECT Imaging In The Prognostic Assessment Of Male Patients With STEMI

Objective:This study aims to investigate the clinical value of rest gated myocardial perfusion SPECT imaging in the prognostic evaluation of male patients with acute ST-segment elevation myocardial infarction.Methods:Seventy male patients with acute STEMI were collected from July 2014 to December2014 of cardiovascular dept in the First Hospital of Shanxi Medical University hospital.General information including age, history of hypertension and diabetes, therapies were recorded. Venous blood was drawn from all patients and NT-pro BNP、c Tn I、hs-CRP concentration were measured. Coronary arteriography(CAG) and rest gated myocardial perfusion SPECT imaging(G-MPI) were performed in all patients to measured the left ventricular end diastolic volume(LVEDV)、left ventricular end systolic volume(LVESV)and left ventricular ejection fraction(LVEF), and the myocardial perfusion defect area was calculated. All patients were followed within 180 days after discharge to record the major adverse cardiovascular events(MACE). According to the follow-up results, patients were assigned to MACE group and non-MACE group, the value of prognostic evaluation between myocardial perfusion defect area and NT-pro BNP was analyzed by receiver operating characteristic curve(ROC curve). According to the best cut-off value of myocardial perfusion defect area which determined by ROC curve analysis, patients were divided into tow groups, then drawn the Kaplam-Meier survival curve.Results:1. The myocardial perfusion defect area in STEMI patients is uncorrelated with c Tn I and hs-CRP concentration(P>0.05), and positive correlation with NT-pro BNPconcentration(r=0.793, P<0.05). The myocardial perfusion defect area in STEMI patients is uncorrelated with LVEDV and LVESV(P>0.05), and negative correlation with LVEF(r=-0.609, P<0.05).2. The level of age、history of hypertension and diabetes、HDL-C、LDL-C、hs-CRP、c Tn I、LVEDV、LVESV and LVEF among the MACE group and non-MACE group, had no statistically significant differences(P>0.05). There were apparent differences between the MACE group and non-MACE group, which in the myocardial perfusion defect area、NT-pro BNP concentration and vascular lesion, the differences were statistically significant(P<0.05 or 0.01).3. ROC curve analysis showed that the area under the curve of myocardial perfusion defect area was 0.700(cut-off value=14.06%, sensitive=84.2%, specificity=62.5%, Youden index=0.467,P<0.05). And the area under the curve of NT-pro BNP concentration was0.644(cut-off value=1609 ng/L, sensitive=44.7%, specificity=87.5%, Youden index=0.322,P<0.05). The difference of the area under the ROC curve among two predictors had statistically significant(P<0.05). Combined testing( sensitive=94.7%,specificity=50.0%, Youden index=0.447,P<0.05).4. There were obvious differences in MACE incidence between the two group, the differences were statistically significant(P<0.05).Conclusion:1. The value of myocardial perfusion defect area in the prognostic evaluation of MACE with male STEMI patients was better than NT-pro BNP concentration.2. Myocardial perfusion defect area can be a predictor of risk stratification in male STEMI patients, predict the risk of MACE, and the best cut-off value of myocardial perfusion defect area was 14.06%.