Abstract 3025: Prognostic Utility of Myocardial SPECT with Iodine-123-beta-methyl Iodophenyl-pentadecanoic Acid (BMIPP) in Risk Stratification of Patients with Acute Chest Pain
Background: Iodine-123-beta-methyl iodophenyl-pentadecanoic acid (BMIPP) can assess fatty acid utilization by the myocardium. Previous clinical studies have shown that abnormal BMIPP uptake reflects metabolic alternations because of severe ischemic attack. The purpose of this study was to evaluate the prognostic information of BMIPP myocardial SPECT to predict the long term outcome of patients with acute chest pain.
Methods: This study included 397 consecutive patients with acute chest pain. Resting dual isotope (201TlCl and BMIPP) myocardial SPECT was performed within 3 days after the last episode of chest pain. Dual myocardial SPECT findings were analyzed qualitatively and quantitatively in blind manner, and positive findings (abnormal uptake of BMIPP) were interpreted from comparison with the findings of 201TlCl perfusion images.
Results: All the patients were divided into the positive finding group (group A: n=281) and the negative finding group (group B: n=116). By the end of follow up period ( mean 18.2 months ), coronary intervention therapy was needed for 121 patients (43%) in group A, 14 patients in group B (12%). Five cardiac deaths were found in group A, and no cardiac death was found in group B. On multivariate analysis, positive finding of BMIPP was identified as independent factor for cardiac events.
Conclusion: The treatment based on the findings of BMIPP myocardial SPECT improves long term risk prediction of cardiac events with acute chest pain.