Int J Med Sci 2011; 8(8):717-724. doi:10.7150/ijms.8.717

Research Paper

A Paired-Comparision of the MultiFunction CardioGramsm (MCG) and Sestamibi SPECT Myocardial Perfusion Imaging (MPI) to Quantitative Coronary Angiography for the Detection of Relevant Coronary Artery Obstruction (≥70%) - A Single-Center Study of 116 Consecutive Patients Referred for Coronary Angiography

John E. Strobeck1,2✉, Anthony Mangieri1, Norbert Rainford3

1. Heart-Lung Center, Hawthorne, NJ, USA.
2. The Valley Hospital, Ridgewood, NJ, USA.
3. Columbia Presbyterian Medical Center, New York, NY, USA.

Abstract

Background: An analysis of the US National Cardiovascular Data Registry has revealed that only 38% of patients referred for coronary angiography after non-invasive coronary testing have relevant coronary obstruction (CO) (≥70%) of one or more coronary arteries.

Methods: A single-center trial was undertaken in 165 consecutive, symptomatic patients with either known or suspected coronary disease and/or valve disease(VHD) who agreed to undergo cardiac catheterization and coronary angiography if stress myocardial perfusion imaging was abnormal. A total of 116 patients with abnormal SPECT MPI tests, persistent chest pain, or significant VHD underwent final analysis. An MCG coronary obstruction (CO) score of ≥ 4.0 was considered indicative of relevant CO (≥70%) in one or more coronary arteries. Angiographic results were finalized by consensus of two angiographers.

Results: CO (≥70%) was present in 53 of 116 patients (46%). The MCG CO score was significantly higher for patients with relevant CO (5.4 ± 1.9 vs. 2.5 ± 1.9). The MCG correctly classified 103 of the 116 patients (89%) enrolled in the study as either having or not having CO (≥70%) (sensitivity- 91%; specificity- 87%; NPV- 92%; PPV- 86%). SPECT MPI was abnormal in 99 of the 116 (85%) patients undergoing catheterization, but correctly classified only 54 of the 116 patients (47%) entered in the study as either having or not having relevant CO (sensitivity-85%; specificity-14%; NPV - 53%; PPV- 45%).

Conclusions: The MCG was shown in this paired-comparison trial with SPECT MPI to safely and accurately identify patients with relevant CO (≥70%) prior to catheterization.

Keywords: Coronary Angiography, Coronary Artery Stenosis, MultiFunction CardioGram

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How to cite this article:
Strobeck JE, Mangieri A, Rainford N. A Paired-Comparision of the MultiFunction CardioGramsm (MCG) and Sestamibi SPECT Myocardial Perfusion Imaging (MPI) to Quantitative Coronary Angiography for the Detection of Relevant Coronary Artery Obstruction (≥70%) - A Single-Center Study of 116 Consecutive Patients Referred for Coronary Angiography. Int J Med Sci 2011; 8(8):717-724. doi:10.7150/ijms.8.717. Available from http://www.medsci.org/v08p0717.htm