Patricia Oliveira, Presenter: Nothing to Disclose

Elisabete Martins, Abstract Co-Author: Nothing to Disclose

Helder Quirino Fernandes MD, Abstract Co-Author: Nothing to Disclose

José Pedro Henriques Patrício MD, Abstract Co-Author: Nothing to Disclose

Maria Teresa Faria, Abstract Co-Author: Nothing to Disclose

Jorge Pereira MD, Abstract Co-Author: Nothing to Disclose

Ana Cristina Oliveira, Abstract Co-Author: Nothing to Disclose

João Carlos Silva MD, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

Our aim was to analyze the findings and determine the prognostic value of MPS in pts with angiographically normal/near normal coronary arteries (nNCA).

From the pts submitted to MPS in our dpt, for pre-surgical risk assessment or management of chest pain, between 01-01-2006 and 30-06-2008, we selected those with angiographically nNCA (minor coronary irregularities up to 50% stenoses), with a maximum interval of 6 months from CPM and without cardiac/coronary disease. We reviewed the MPS findings and assessed the occurrence of cardiovascular events (CVE) during follow-up. Follow-up data was obtained by direct pt questioning and review of clinical records. Cardiovascular risk factors (CVRF) were also assessed: diabetes mellitus, hypertension, chronic renal insufficiency, smoking habits, peripheric vascular disease, cerebrovascular disease, dyslipidemia and family history of coronary disease. The body mass index was calculated.

From the 188 pts submitted to MPS for pre-surgical risk assessment or management of chest pain during the defined period, 40 pts were selected. 23 were female (57.5%), and mean age was 60.5±11.4 ys. 23 pts (57.5%) had at least 7 CVRF’s, 13 (32.5%) were under anti-ischemic medications and 7 (17.5%) were prescribed ACEi. MPSs revealed a mean summed stress score of 6.7±3.3. 25 pts (62.5%) had one mild perfusion defect, 8 (20%) had moderate/severe perfusion defects and 3 (7.5%) had a normal/near normal MPS. During the follow-up period (16.8±9.2 mths), 5 patients (12.5%) had recurrent chest pain for which they sought medical care and 1 (2.5%) had an acute coronary syndrome.

Our pool of pts with angiographically nNCA had a high risk for coronary artery disease (multiple CVRF’s). In fact, despite nNCA, most had perfusion defects. These probably reflect microvascular dysfunction secondary to an early stage of atherosclerosis revealing its functional impact in MPS, and should be taken into account in the management of these pts. We found few CVE during the follow-up, but the fact that a high percentage of pts (50%) was under cardioprotective medication might have influenced our results.

Angiographicaly insignificant coronary disease may be associated to scintigraphic perfusion defects that probably reflect microvascular dysfunction secondary to an early stage of atherosclerosis.

Oliveira, P, Martins, E, Fernandes, H, Patrício, J, Faria, M, Pereira, J, Oliveira, A, Silva, J, et al, 0, Prognostic Value of Myocardial Perfusion Scintigraphy in Patients with Angiographically Normal/Near-Normal Coronary Arteries.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8011793.html