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Title: Prediction of multivessel coronary artery disease and prognosis early after acute myocardial infarction by exercise electrocardiography and thallium-201 myocardial perfusion scanning

Abstract

Exercise electrocardiography and thallium scanning were performed a mean of 24 days after uncomplicated acute myocardial infarction in 103 patients, aged 36 to 60 years, who also underwent coronary angiography. The purpose of the study was to determine the ability of the noninvasive tests to predict multivessel coronary artery disease (CAD) and prognosis. Patients were followed up to document medical complications (incidence 12%: 3 deaths, 1 resuscitated cardiac arrest, 4 recurrent infarctions, 4 admissions with unstable angina) and combined events (medical events or bypass surgery, incidence 23%). The sensitivity, specificity and predictive accuracy for predicting multivessel CAD were 64%, 77% and 64% for a positive exercise electrocardiographic (ECG) response, 64%, 88% and 80% for a remote thallium defect, and 42%, 96% and 88% for a combination of the 2 tests. With 2 tests yielding negative findings the probability of multivessel CAD was 13%. No variable (positive exercise ECG response, remote thallium defect and presence of multivessel CAD) predicted medical events, although there were nonsignificant trends to more events in patients with any of those findings. The relative risk of combined events was 2.5 (p less than 0.05) for a positive exercise ECG response; 1.8 (NS) for a remote thallium defect;more » 2.6 (p less than 0.05) for multivessel CAD; and 3.1 (p less than 0.025) for both positive ECG response and remote defect. A combination of exercise electrocardiography and thallium scanning early after acute myocardial infarction helps to identify subsets of patients with high and low probabilities of multivessel CAD and combined medical or surgical events.« less

Authors:
; ; ; ; ; ;
Publication Date:
Research Org.:
Hallstrom Institute of Cardiology, Sydney, Australia
OSTI Identifier:
5008369
Resource Type:
Journal Article
Journal Name:
Am. J. Cardiol.; (United States)
Additional Journal Information:
Journal Volume: 6
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARDIOVASCULAR DISEASES; DIAGNOSIS; MYOCARDIAL INFARCTION; MYOCARDIUM; RADIOISOTOPE SCANNING; BIOMEDICAL RADIOGRAPHY; ELECTROCARDIOGRAMS; HEART; PATIENTS; PERFUSED TISSUES; THALLIUM 201; ANIMAL TISSUES; BETA DECAY RADIOISOTOPES; BODY; CARDIOVASCULAR SYSTEM; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DIAGRAMS; DISEASES; ELECTRON CAPTURE RADIOISOTOPES; HEAVY NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; MEDICINE; MUSCLES; NUCLEAR MEDICINE; NUCLEI; ODD-EVEN NUCLEI; ORGANS; RADIOISOTOPES; RADIOLOGY; SECONDS LIVING RADIOISOTOPES; THALLIUM ISOTOPES; TISSUES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats

Abraham, R.D., Freedman, S.B., Dunn, R.F., Newman, H., Roubin, G.S., Harris, P.J., and Kelly, D.T. Prediction of multivessel coronary artery disease and prognosis early after acute myocardial infarction by exercise electrocardiography and thallium-201 myocardial perfusion scanning. United States: N. p., 1986. Web. doi:10.1016/0002-9149(86)90008-1.
Abraham, R.D., Freedman, S.B., Dunn, R.F., Newman, H., Roubin, G.S., Harris, P.J., & Kelly, D.T. Prediction of multivessel coronary artery disease and prognosis early after acute myocardial infarction by exercise electrocardiography and thallium-201 myocardial perfusion scanning. United States. doi:10.1016/0002-9149(86)90008-1.
Abraham, R.D., Freedman, S.B., Dunn, R.F., Newman, H., Roubin, G.S., Harris, P.J., and Kelly, D.T. Mon . "Prediction of multivessel coronary artery disease and prognosis early after acute myocardial infarction by exercise electrocardiography and thallium-201 myocardial perfusion scanning". United States. doi:10.1016/0002-9149(86)90008-1.
@article{osti_5008369,
title = {Prediction of multivessel coronary artery disease and prognosis early after acute myocardial infarction by exercise electrocardiography and thallium-201 myocardial perfusion scanning},
author = {Abraham, R.D. and Freedman, S.B. and Dunn, R.F. and Newman, H. and Roubin, G.S. and Harris, P.J. and Kelly, D.T.},
abstractNote = {Exercise electrocardiography and thallium scanning were performed a mean of 24 days after uncomplicated acute myocardial infarction in 103 patients, aged 36 to 60 years, who also underwent coronary angiography. The purpose of the study was to determine the ability of the noninvasive tests to predict multivessel coronary artery disease (CAD) and prognosis. Patients were followed up to document medical complications (incidence 12%: 3 deaths, 1 resuscitated cardiac arrest, 4 recurrent infarctions, 4 admissions with unstable angina) and combined events (medical events or bypass surgery, incidence 23%). The sensitivity, specificity and predictive accuracy for predicting multivessel CAD were 64%, 77% and 64% for a positive exercise electrocardiographic (ECG) response, 64%, 88% and 80% for a remote thallium defect, and 42%, 96% and 88% for a combination of the 2 tests. With 2 tests yielding negative findings the probability of multivessel CAD was 13%. No variable (positive exercise ECG response, remote thallium defect and presence of multivessel CAD) predicted medical events, although there were nonsignificant trends to more events in patients with any of those findings. The relative risk of combined events was 2.5 (p less than 0.05) for a positive exercise ECG response; 1.8 (NS) for a remote thallium defect; 2.6 (p less than 0.05) for multivessel CAD; and 3.1 (p less than 0.025) for both positive ECG response and remote defect. A combination of exercise electrocardiography and thallium scanning early after acute myocardial infarction helps to identify subsets of patients with high and low probabilities of multivessel CAD and combined medical or surgical events.},
doi = {10.1016/0002-9149(86)90008-1},
journal = {Am. J. Cardiol.; (United States)},
number = ,
volume = 6,
place = {United States},
year = {1986},
month = {9}
}