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OBJECTIVES: To assess the prognostic value of gated-SPECT myocardial perfusion imaging (MPI) in women after acute coronary syndrome (ACS), as well as to evaluate whether the intraventricular dyssynchrony shows any difference in women according to the type of ACS.
METHODS: Ninety women (mean age: 58±9 years) admitted between April 2011 and April 2014 with diagnosis of ACS were included. They were divided in two groups: those with ST elevation myocardial infarction (STEMI) (group 1, 54 patients), and those with non-ST elevation myocardial infarction (NSTEMI) (group 2, 36 patients). All underwent a gated-SPECT two-day MPI with a stress - rest protocol. A one year clinical follow-up was done.
RESULTS: Summed stress (SSS) and rest scores (SRS) were significantly greater in STEMI patients (11.33 vs. 4.86 for SSS, and 8.24 vs. 2.66 for SRS). Left ventricular ejection fraction was significantly higher in those with NSTEMI (both post-stress: 68.75% vs. 58.54% in STEMI, and at rest: 67.22% vs. 58.75%). Phase-derived standard deviation and histogram bandwidth were significantly different between both groups. STEMI patients showed a more asynchronous behavior. Fourteen adverse cardiac events appeared during follow-up. SSS and the percentage of maximal heart rate (MHR) achieved during maximal stress were associated with the occurrence of cardiac events in NSTEMI patients, but not in those with STEMI.
CONCLUSION: A gated-SPECT MPI can be useful to risk stratifies women after ACS. SSS and percentage of MHR were the best predictors of adverse cardiac events among NSTEMI patients. STEMI patients showed a more asynchronous behavior.