Authors: Shmuel Rispler Doron Aronson Sobhi Abadi Ariel Roguin Ahuva Engel Rafael Beyar Ora Israel Zohar Keidar
Publish Date: 2011/06/18
Volume: 38, Issue: 10, Pages: 1917-1925
Abstract
Early risk stratification in patients with nonST elevation acute coronary syndromes NSTEACS is important since the benefit from more aggressive and costly treatment strategies is proportional to the risk of adverse clinical events In the present study we assessed whether hybrid single photon emission computed tomography SPECT/coronary computed tomography angiography CCTA technology could be an appropriate tool in stratifying patients with NSTEACSSPECT/CCTA was performed in 90 consecutive patients with NSTEACS The Thrombolysis in Myocardial Infarction risk score TIMIRS was used to classify patients as low or highrisk Imaging was performed using SPECT/CCTA to identify haemodynamically significant lesions defined as 50 stenosis on CCTA with a reversible perfusion defect on SPECT in the corresponding territoryCCTA demonstrated at least one lesion with 50 stenosis in 35 of 40 highrisk patients 87 as compared to 14 of 50 lowrisk patients 35 TIMIRS 3 p 00001 Of the 40 highrisk and 50 16 lowrisk TIMIRS patients 16 40 and 8 16 respectively had haemodynamically significant lesions p = 001 Patients defined as highrisk by a high TIMIRS a positive CCTA scan or both n = 45 resulted in a sensitivity of 95 specificity of 49 PPV of 35 and NPV of 97 for having haemodynamically significant coronary lesions Those with normal perfusion were spared revascularization procedures regardless of their TIMIRS
Keywords: