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2016, Number 1

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Rev Cubana Cardiol Cir Cardiovasc 2016; 22 (1)

Myocardial perfusion imaging versus other techniques in the diagnosis of coronary stenosis

Padrón GKM, Peix GAT, Cabrera RLO, Reyes N, Rodríguez-Nande L, Ferrero LL, Chacón D

Language: Spanish
References: 28
Page: 25-34
PDF size: 437.22 Kb.


ABSTRACT

Introduction and objectives: Myocardial perfusion imaging with SPECT is a widely established method for non-invasive evaluation of coronary artery stenosis. However, the diagnostic value of SPECT to detect coronary artery disease has not been well established. In our center, this technique was introduced in 2009. This is the first pilot study to investigate the diagnostic value of SPECT versus calcium scoring and stress test, in the detection of coronary artery disease, in our institution.
Methods: A prospective, analytical study included fifty consecutive patients with diagnostic gated-SPECT and previous calcium scoring, who were submitted to an invasive coronary angiography. They underwent a gated-SPECT Myocardial Perfusion Imaging following a two-day protocol (stress-rest). We compared patients with and without significant coronary stenosis. The diagnostic security was studied by sensibility, specificity, predictive value, verisimilitude reason, accuracy proportion, Youden index and Kappa de Fleiss me-thods. The statistical signification was fixed in p ‹ 0.05.
Results: The calcium scoring value and all summed perfusion scores were significantly higher in the positive angiography group (p ‹ 0.000). The concordance (Kappa=0.12) and the efficiency (Youden=0.13) of the stress test compared to the angiography were poor. The calcium scoring had the highest specificity (82%), while the gated-SPECT had the highest sensitivity and negative predictive value (95% both), accuracy (82%) and concordance (Kappa=0.65) with the angiography. It also identified better patients with micro-vascular angina.
Conclusions: The gated-SPECT had the best diagnostic security to determine coronary diseases versus the others non-invasive techniques.


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