Evaluation of the diagnostic and prognostic use of gated myocardial perfusion single-photon emission computed tomography in patients with acute chest pain: comparison with the SYNTAX score.
OBJECTIVE
The aim of this study was to evaluate the diagnostic and prognostic efficacy of gated single-photon emission computed tomography (GSPECT) in patients with acute chest pain and to compare quantitative GSPECT parameters and the coronary angiographic SYNTAX score.


METHODS
A total of 168 patients who presented with clinical symptoms of acute chest pain were enrolled in the study. Study participants were divided into two groups according to the risk of acute coronary syndrome (ACS): low-intermediate and high risk. All participants underwent rest or stress-GSPECT (R/S-GSPECT). Coronary angiography was performed in all high-risk patients and the SYNTAX score was determined. All patients were followed for 24 ± 3 months and monitored for the occurrence of major adverse coronary events (MACE).


RESULTS
Among patients with low-intermediate ACS risk, R-GSPECT and S-GSPECT were associated with 100 and 86% sensitivity, 99 and 98% specificity, 100 and 98% negative predictive value, 80 and 86% positive predictive value, and 98 and 97% accuracy, respectively. At follow-up, MACE occurred in 16 patients. Among high-risk patients, GSPECT quantitative parameters were the most significant predictors of MACE in Cox regression analysis.


CONCLUSIONS
R/S-GSPECT, a noninvasive diagnostic method, is associated with an excellent safety profile and exceptional diagnostic and prognostic accuracy in cases of ACS.
aDepartment of Nuclear Medicine, Bozok University School of Medicine, Yozgat Departments of bNuclear Medicine cCardiology dEmergency Medicine, Erciyes University School of Medicine, Kayseri eDepartment of Cardiology, Mersin University School of Medicine, Mersin, Turkey.
Seyhan
S
Karacavus
Ahmet
A
Tutus
Ramazan
R
Topsakal
Mustafa
M
Kula
Ahmet
A
Celik
Ummuhan
U
Abdulrezzak
Polat
P
Durukan
D000208:Acute Disease; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; D002637:Chest Pain / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D011379:Prognosis; D012306:Risk