Search

Coronary angiography has diagnostic limitation in identifying non-stenotic coronary lesion (NSCL) responsible for ischemia. Myocardial perfusion defects in patients (pts) with NSCL have often been unreasonably considered by invasive cardiologists as being "false positive". We evaluated a prognostic value of gated SPECT MPI in unselected group of the pts with NSCL over a 24 month period of follow-up. 170 pts (115 males, 67.6%; age 42-68 years; mean age 56.4+9.2 years) with NSCL (stenosis of 50% or less of LAD and 70% or less of any other coronary artery or its major branches) were enrolled into the study. Retrospective analysis of 86 pts with NSCL and subsequent positive MPS performed within 6 months from the time of coronary angiography (study group) and 84 pts with normal scan results (control group) was performed. Follow-up period was for24 months fromthe timeof MPIor up to the time ofmajor coronary event (MCE) first occurrence of cardiac death or myocardial infarction. Over a two-year follow-up, approximately 11% of the pts in study group had MCE as compared to 3.2% in the control group (P , .01). Abnormal MPI, EF , 35% and high levels of hs-CRP were independent predictors for MCE in the study group. In multivariate analysis only an abnormal MPI remained to be an independent predictor regardless of size or severity of perfusion abnormalities (P ,.005). Pts with NSCL on coronary angiography and myocardial perfusion defects have relatively highevent rate (11%) ofMCE overaperiodof24months fromthe timeofMPI. So,wehighly recommend gated SPECT MPI to be obligatory performed in all cases of NSCL to avoid life-threatening coronary complications in forthcoming future.