Prognostic value of rest gated myocardial perfusion SPECT imaging in male patients with ST-segment elevation myocardial infarction

Abstract

Objective To investigate the prognostic value of rest gated myocardial perfusion SPECT imaging (GMPI) in male patients with ST-segment elevation myocardial infarction (STEMI). Methods Seventy male patients with acute STEMI were collected from July 2014 to December 2014. General information including age, history of hypertension, diabetes and serum levels of NT-proBNP, cTnI, hs-CRP were recorded. CAG and rest GMPI were performed to measure the LVEDV, LVESV, LVEF, and the percentage of myocardial perfusion defect size (PMPDS) was calculated. All patients were followed at least 180 d and the major cardiac events (MACE) were recorded. According to the follow-up results, patients were assigned to MACE group and non-MACE group, the prognostic value of PMPDS and NT-proBNP for MACE was analyzed by ROC curve. According to the cut-off value of PMPDS, patients were divided into 2 groups, and Kaplan-Meier survival curve were drawn. The data were analyzed by two-sample t test, Mann-Whitney u test, χ2 test, Pearson correlation analysis and log-rank test. Results The PMPDS in STEMI patients was not correlated with cTnI, hs-CRP, LVEDV and LVESV (all P>0.05), while positively correlated with NT-proBNP(r=0.793, P 0.05). The PMPDS, NT-proBNP, and number of stenotic vessels were significantly different between the two groups (t=2.4, z values: -2.1 and -3.6; all P<0.05). ROC curve analysis showed that the AUC of PMPDS was 0.700 with cut-off value of 14.06%, which was better than that of NT-proBNP (z=2.1, P<0.05). When patients were separated according to the cut-off value of 14.06%, there were significant differences in MACE incidence rates between the two groups (P<0.01). Conclusion Compared with NT-proBNP, PMPDS has a better prognostic value for predicting the MACE risk within 180 d in male STEMI patients, and can be used for the risk stratification of STEMI patients. Key words: Myocardial infarction; Male; Prognosis; Myocardial perfusion imaging; Tomography, emission-computed, single-photon; Technetium Tc 99m sestamibi