ATP stress ⁹⁹Tc^m-MIBI gated myocardial perfusion imaging in diagnosis of in-stent restenosis

Objective: To investigate the value of ATP stress ⁹⁹Tc^m-MIBI G-MPI in evaluating in-stent restenosis. Methods: Seventy-one patients (56 males, 15 females, age range: 37-83 (60.2 ± 9.5) yeas) who had undergone coronary stent implantation at least 3 months ago, accompanying a typical angina pectoris symptom, were included in this perspective study. All patients underwent ATP stress ⁹⁹Tc^m-MIBI G-MPI and CAG (gold standard) within 1 month. The diagnostic efficiency of ATP stress ⁹⁹Tc^m-MIBI G-MPI on in-stent restenosis was evaluated- Fisher exact probability method was used to analyze data with SPSS 17.0. Results: Five patients were excluded because of new stenosis. According to the results of CAG, 39 patients with 45 coronary arteries showed in-stent restenosis among 66 patients with 99 coronary arteries. There were 19 patients with myocardial infarction among the 39 patients with in-stent restenosis. Contrarily, there were 16 patients with myocardial infarction among the 27 patients without in-stent restenosis. The diagnostic Se, Sp, Ac, PPV and NPV of ATP stress ⁹⁹Tc^m-MIBI G-MPI for in-stent restenosis were 85%(33/39), 89%(24/27), 86%(57/66), 92%(33/36) and 80%(24/30), respectively in 66 patients. Those were 79%(15/19), 88%(14/16), 83%(29/35), 88%(15/17) and 78%(14/18) in patients with myocardial infarction, and 90%(18/20), 91%(10/11), 90%(28/31), 95%(18/19) and 83%(10/12) in patients without myocardial infarction (all P > 0.05). Conclusion: ATP stress ⁹⁹Tc^m-MIBI G-MPI has high diagnostic efficiency in evaluating in-stent restenosis. (authors)