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GW24-e0530 The value of ATP stress 99mTc-MIBI gated myocardial perfusion imaging for evaluating stent restenosis after coronary stent implantation
  1. Zhang Pengfei,
  2. Wang Lijuan
  1. Department of Cardiology, The First Affiliated Hospital of China Medical University

Abstract

Objectives To investigate the value of ATP stress 99mTc-methoxyisobutylisonitrile (99mTc-MIBI) gated myocardial perfusion imaging (G-MPI) for evaluating stent restenosis after coronary stent implantation.

Methods 66 patients with coronary stent implantation more than 3 months, accompanying a typical angina pectoris symptom. All patients underwent ATP stress 99mTc-MIBI G-MPI and coronary angiography (CAG) within 1 month. Compared with CAG, we calculated the sensitivity, specificity and accuracy of ATP stress G-MPI in judging stent restenosis after coronary stent implantation.

Results 66 patients with 99 coronary arteries underwent stent implantation, 39(59%) patients, 45(45 %) coronary arteries appeared in-stent restenosis. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ATP stress G-MPI in judging stent restenosis for all patients were 85% (33/39), 89% (24/27), 86% (57/66), 92% (33/36) and 80% (24/30); for patients with myocardial infarction were 79% (15/19), 88% (14/16), 83% (29/35), 88% (15/17) and 78% (14/18), for patients with non-myocardial infarction were 90% (18/20), 91% (10/11), 90% (28/31), 95% (18/19) and 83% (10/12). The diagnostic value in the patients with non- myocardial infarction patients were higher than that in patients with non- myocardial infarction, but there no significant difference between two patients groups. The diagnostic sensitivity, specificity and accuracy of ATP stress G-MPI in judging stent restenosis for left anterior descending artery stent restenosis were 83% (20/24), 89% (16/18) and 86% (36/42) ,for left circumflex artery stent restenosis were 83% (5/6), 81% (13/16) and 82% (18/22), for right coronary artery stent restenosis were 80% (12/15), 75% (15/20) and 77% (27/35). The diagnostic sensitivity, specificity and accuracy for patients with 1 branch vessel lesion were 80% (8/10), 100% (5/5) and 87% (13/15), for patients with 2 -ranch vessel lesion were 91% (10/11), 82% (9/11) and 86% (19/22),for patients with 3 -ranch vessel lesion were 83% (15/18), 91% (10/11) and 86% (25/29).

Conclusions ATP stress 99mTc-MIBI G-MPI has significant clinical value for diagnosing stent restenosis after coronary stent implantation.

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