Evaluation of curative effect by intravenous nitroglycerin gated myocardial perfusion imaging on acute coronary syndrome patients treated by percutaneous coronary intervention

Abstract

Objective To evaluate the curative effect of percutaneous coronary intervention (PCI) on patients with acute coronary syndrome (ACS), using intravenous nitroglycerin 99Tcm-MIBI SPECT gated myocardial perfusion imaging. Methods Forty cases of ACS including 17 cases of myocardial infarction (coronary occlusion) and 23 cases of unstable angina pectoris (coronary stenosis) were analyzed retrospectively. All patients were treated by PCI, and intravenous nitroglycerin 99Tcm-MIBI SPECT gated myocardial perfusion imaging were performed for all patients within a weeks before PCI and one to two months after PCI. The reversible and irreversible defect segment number, the effective rate of the treatment and ejection fraction (EF) were recorded to analyze. Results The treatment efficiency of PCI on coronary occlusion therapy in patients with reversible defect was 67.3%(37/55), that in patients with irreversible defects was 26.7% (8/30), the latter was obviously lower than the former (χ2=12.85, P<0.05). The total effective rate of PCI in coronary occlusion was 52.9% (45/85), that in coronary artery stenosis was 76.7% (69/90), the latter was higher than the former (χ2=10.84, P<0.05). Conclusions Nitroglycerin 99Tcm-MIBI SPECT gated myocardial perfusion imaging is an effective means to evaluate the efficacy of PCI in ACS patients. Schemic myocardium can gain normal perfusion by PCI treatment, and gain reperfusion for live myocardium with coronary infarction. But for the majority of irreversible myocardial infarction, the value of PCI treatment is limited. Key words: Acute coronary syndrome; Percutaneous coronary intervention; Myocardial perfusion imaging; Nitroglycerin