Relationship between the location of the most severe myocardial perfusion defects, the most severe coronary artery stenosis and the site of subsequent myocardial infarction [Persian]

This study evaluated the relationship between the location of the most severe coronary artery stenosis and the subsequent acute myocardial infarction (AMI). Methods: Of 1590 patients who were admitted with a diagnosis of AMI, we identified 44 patients who had undergone previous myocardial perfusion SPECT. Thirty-one of these patients also had previous coronary angiography. The relationship between the location of the myocardial perfusion defects, the coronary artery stenosis and site of subsequent AMI were studied in these patients. Results: The concordance between the location of the most severe reversible defects detected by SPECT and the site of subsequent AMI was 71% (k=0.499). The concordance between the most severe stenosis detected by coronary angiography and the site of subsequent AMI was 64% (k=0.451). Conclusion: The culprit lesion is not always the one that is manifested by the most severe reversible perfusion defect or the most critical coronary stenosis. Myocardial SPECT and coronary angiography can peredict the location of a future AMI in 71% and 64% of patients respectively. The percentage is higher when the interval between investigations and subsequent AMI is <3 month, for moderate to severe perfusion defects and for 90-99% coronary stenosis.