Prognostic value of computer-quantitated exercise thallium imaging early after percutaneous transluminal coronary angioplasty

Journal Article · Sat Aug 01 00:00:00 EDT 1987 · J. Am. Coll. Cardiol.; (United States)

DOI:https://doi.org/10.1016/S0735-1097(87)80008-6· OSTI ID:6215761

Miller, D D; Liu, P; Strauss, H W; Block, P C; Okada, R D; Boucher, C A

To develop an approach to predicting adverse events after percutaneous transluminal coronary angioplasty (PTCA), 50 patients had thallium-201 exercise testing within 1 month after successful single vessel coronary angioplasty and were followed up for a mean of 18 months. Adverse events were: 1) clinical events consisting of recurrent angina (17 patients) and myocardial infarction (1 patient); 2) treatment events consisting of repeat coronary angioplasty (10 patients) and coronary bypass surgery (1 patient); and 3) restenosis, defined as a greater than 30% increase in luminal stenosis (15 of 38 recatheterized patients). There were no deaths. Of the clinical, exercise, angiographic and thallium scan variables analyzed by stepwise logistic regression, postangioplasty gradient greater than 20 mm Hg predicted clinical events and treatment events, and the number of segments with slower thallium clearance predicted clinical events, treatment events and restenosis. Using Cox Hazards model regression of survival without events, the number of transient qualitative thallium defects also predicted clinical events and restenosis. At 1 year after angioplasty, 24% of patients with these variables had restenosis compared with only 6% of those without these variables and 36% of patients with these variables had a clinical or treatment event compared with 8% of patients without these variables. Three measures of the adequacy of myocardial perfusion (post-angioplasty gradient, reduced thallium clearance and transient thallium defects) were additive predictors of adverse events after coronary angioplasty with the relative risk being approximately four times greater in patients with these variables than in those without. Such adverse events, therefore, are usually a consequence of inadequate revascularization.

• Research Organization: Massachusetts General Hospital, Boston, MA (United States)
• OSTI ID: 6215761
• Journal Information: J. Am. Coll. Cardiol.; (United States), Vol. 10:2
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARDIOVASCULAR DISEASES
DIAGNOSIS
HEART
RADIOISOTOPE SCANNING
COMPUTER CALCULATIONS
EXERCISE
FORECASTING
PATIENTS
REGRESSION ANALYSIS
SURGERY
SURVIVAL TIME
THALLIUM 201
BETA DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MATHEMATICS
MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
STATISTICS
THALLIUM ISOTOPES
550601* - Medicine- Unsealed Radionuclides in Diagnostics