Prognostic value of rest gated myocardial perfusion SPECT imaging in male patients with ST-segment elevation myocardial infarction / 中华核医学与分子影像杂志

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 infonnation 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 KaplanMeier survival curve were drawn.The data were analyzed by two-sample t test,Mann-Whitney u test,x2 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),and negatively correlated with LVEF (r=-0.609,P＜0.05).Between MACE group and non-MACE group,there was no statistical differences in age,history of hypertension,diabetes,serum levels of HDL-C,LDL-C,hs-CRP,cTnⅠ,LVEDV,LVESV,and LVEF (x2 values0.21 and 0.37,z values-1.0 and-1.2,t valuesfrom-1.6 to 1.5;all 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.