A multi-center trial on the study of ATP stress myocardial perfusion imaging in the detection of coronary artery disease

Objective To assess the value of ATP stress MPI (ATP-MPI) in the detection of coronary artery disease (CAD).Methods A total of 214 patients (156 males,58 females,age:10-83(60.96±11.60) years) of 5 hospitals from July 2012 to October 2013 were recruited.They all underwent ATPMPI and CAG within 1 month.ATP was infused intravenously at a speed of 0.16 mg · kg-1 · min-1 for 5 min.Adose of 925 MBq 99Tcm-MIBI was injected intravenously after 3 min of ATP infusion,and patients were monitored for 1 more minute after completion of ATP infusion.ATP-MPI was performed 1 h later and rest MPI was performed on the next day.Reversible perfusion defects were diagnosed as myocardial ischemia and fixed defects as myocardial infarct.The diagnostic efficiency was evaluated with CAG as the gold standard.Results Of the 214 patients,94 patients (43.9％) had negative findings; 47 patients(22.0％) had one vessel disease; 22 patients (10.3％) had two vessel disease and 51 patients(23.8％) had three vessel disease,including 4 with left main coronary artery disease.There were 106 patients (49.5％) with normal ATP-MPI and 108 patients(50.5％) with abnormal ATP-MPI,the latter of which consisted of 65 (60.2％)with reversible defects,15(13.9％) with fixed defects and 28(25.9％) with mixed defects.The mean abnormal segments detected by ATP-MPI were 4.2±2.4.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of ATP-MPI for the detection of CAD were 84.1％ (180/214),80.8％ (97/120),88.3％ (83/94),89.8％ (97/108) and 78.3％ (83/106),respectively.Conclusion ATP-MPI has high diagnostic efficacy in the detection of CAD,therefore,has potential value to promote for its clinical use. Key words: Coronary disease;  Adenosine triphosphate;  Tomography, emission-computed,single-photon;  MIBI