Thrombolytic therapy for myocardial infarction: Assessment of efficacy by myocardial perfusion imaging with technetium-99m sestamibi

Journal Article · Tue Oct 16 00:00:00 EDT 1990 · American Journal of Cardiology; (USA)

DOI:https://doi.org/10.1016/0002-9149(90)90610-D· OSTI ID:6323446

Wackers, F J ^[1]

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1. Yale Univ. School of Medicine, New Haven, CT (USA)

Technetium-99m (Tc-99m) sestamibi has been used to evaluate the efficacy of thrombolytic therapy. Improved image quality due to the higher photon energy of Tc-99m and the increased allowable doses of this radiopharmaceutical along with its lack of redistribution makes Tc-99m sestamibi an acceptable imaging agent for such studies. This imaging agent was used for serial quantitative planar and tomographic imaging to assess the initial risk area of infarction, its change over time and the relation to infarct-related artery patency in patients with a first acute myocardial infarction. Twenty-three of 30 patients were treated with recombinant tissue-type plasminogen activator (rt-PA) within 4 hours after onset of acute chest pain. Seven patients were treated in the conventional manner and did not receive thrombolytic therapy. The initial area at risk varied greatly both in patients treated with rt-PA and in those who received conventional therapy. Patients with successful thrombolysis and patient infarct arteries had a significantly greater reduction of Tc-99m sestamibi defect size than patients who had persistent coronary occlusion. Serial imaging with Tc-99m sestamibi could find important application in future clinical research evaluating the efficacy of new thrombolytic agents. Direct measurements of the amount of hypoperfused myocardium before and after thrombolysis could provide rapid and unequivocal results using fewer patients and avoiding the use of mortality as an end point. This approach has not yet been widely tested in the clinical arena.

• OSTI ID: 6323446
• Journal Information: American Journal of Cardiology; (USA), Vol. 66:13; ISSN 0002-9149
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
MYOCARDIAL INFARCTION
DIAGNOSIS
RADIOPHARMACEUTICALS
EVALUATION
CHEMOTHERAPY
FIBRINOLYSIN
ISOMERIC NUCLEI
PATIENTS
PLASMINOGEN
TECHNETIUM 99
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
CARDIOVASCULAR DISEASES
DISEASES
DRUGS
ENZYMES
FIBRINOLYTIC AGENTS
HEMATOLOGIC AGENTS
HOURS LIVING RADIOISOTOPES
HYDROLASES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LABELLED COMPOUNDS
NUCLEI
ODD-EVEN NUCLEI
PEPTIDE HYDROLASES
RADIOISOTOPES
SERINE PROTEINASES
TECHNETIUM ISOTOPES
THERAPY
YEARS LIVING RADIOISOTOPES
550601* - Medicine- Unsealed Radionuclides in Diagnostics