Prediction of cardiac events after uncomplicated myocardial infarction: a prospective study comparing predischarge exercise thallium-201 scintigraphy and coronary angiography

Journal Article · Mon Aug 01 04:00:00 EDT 1983 · Circulation; (United States)

DOI:https://doi.org/10.1161/01.CIR.68.2.321· OSTI ID:5022041

Gibson, R S; Watson, D D; Craddock, G B; Crampton, R S; Kaiser, D L; Denny, M J; Beller, G A

The ability of predischarge quantitative exercise thallium-201 (/sup 201/T1) scintigraphy to predict future cardiac events was evaluated prospectively in 140 consecutive patients with uncomplicated acute myocardial infarction; the results were compared with those of submaximal exercise treadmill testing and coronary angiography. High risk was assigned if scintigraphy detected /sup 201/T1 defects in more than one discrete vascular region, redistribution, or increased lung uptake, if exercise testing caused ST segment depression greater than or equal to 1 mm or angina or if angiography revealed multivessel disease. Low risk was designated if scintigraphy detected a single-region defect, no redistribution, or no increase in lung uptake, if exercise testing caused no ST segment depression or angina, or if angiography revealed single-vessel disease or no disease. By 15 +/- 12 months, 50 patients had experienced a cardiac event; seven died (five suddenly), nine suffered recurrent myocardial infarction, and 34 developed severe class III or IV angina pectoris. Compared with that of patients at low risk, the cumulative probability of a cardiac event was greater in high-risk patients identified by scintigraphy, exercise testing, or angiography. Scintigraphy predicted low-risk status better than exercise testing or angiography. Each predicted mortality with equal accuracy. These results indicate that (1) submaximal exercise /sup 201/T1 scintigraphy can distinguish high- and low-risk groups after uncomplicated acute myocardial infarction before hospital discharge; (2) /sup 201/T1 defects in more than one discrete vascular region, presence of delayed redistribution, or increased lung thallium uptake are more sensitive predictors of subsequent cardiac events than ST segment depression, angina, or extent of angiographic disease; and (3) low-risk patients are best identified by a single-region /sup 201/T1 defect without redistribution and no increased lung uptake.

• Research Organization: Univ. of Virginia Hospital, Charlottesville
• OSTI ID: 5022041
• Journal Information: Circulation; (United States), Journal Name: Circulation; (United States) Vol. 68:2; ISSN CIRCA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BIOMEDICAL RADIOGRAPHY
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
EXERCISE
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LUNGS
MEDICINE
MUSCLES
MYOCARDIAL INFARCTION
MYOCARDIUM
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOLOGY
RESPIRATORY SYSTEM
RISK ASSESSMENT
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
THALLIUM 201
THALLIUM ISOTOPES