Prognostic Value of Myocardial Perfusion Gated SPECT in Patients with Symptomatic Intracranial Large-Artery Atherosclerosis

Abstract

Background: We aimed to evaluate the prognostic value of myocardial perfusion gated SPECT in patients with symptomatic intracranial large-artery atherosclerosis (ILA). Methods: Seventy-two consecutive first-ever symptomatic ILA patients without known heart disease underwent a stress myocardial perfusion gated SPECT, and long-term follow-up was conducted thereafter. Results: During an average follow-up of 15.2 ± 9 months, 9 patients (13.8%) presented major coronary events (CEs). Survival analyses (Kaplan-Meier and Cox regression) identified presence of moderate-to-severe myocardial perfusion defects (log rank p = 0.004) and ejection fraction <50% (p = 0.014) as predictors of future CEs. Neurovascular ischemic events were not predicted by SPECT variables. Conclusion: Myocardial perfusion scintigraphy predicts future CEs in patients with symptomatic ILA and may be helpful to guide therapeutic strategies in this subgroup of stroke patients.