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

Abstract

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 thatmore » (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.« less

Authors:
; ; ; ; ; ;
Publication Date:
Research Org.:
Univ. of Virginia Hospital, Charlottesville
OSTI Identifier:
5022041
Resource Type:
Journal Article
Journal Name:
Circulation; (United States)
Additional Journal Information:
Journal Volume: 68:2
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; MYOCARDIAL INFARCTION; DIAGNOSIS; MYOCARDIUM; SCINTISCANNING; THALLIUM 201; BIOMEDICAL RADIOGRAPHY; EXERCISE; LUNGS; PATIENTS; RISK ASSESSMENT; BETA DECAY RADIOISOTOPES; BODY; CARDIOVASCULAR DISEASES; CARDIOVASCULAR SYSTEM; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DISEASES; ELECTRON CAPTURE RADIOISOTOPES; HEART; HEAVY NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; MEDICINE; MUSCLES; NUCLEAR MEDICINE; NUCLEI; ODD-EVEN NUCLEI; ORGANS; RADIOISOTOPE SCANNING; RADIOISOTOPES; RADIOLOGY; RESPIRATORY SYSTEM; SECONDS LIVING RADIOISOTOPES; THALLIUM ISOTOPES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats

Gibson, R.S., Watson, D.D., Craddock, G.B., Crampton, R.S., Kaiser, D.L., Denny, M.J., and Beller, G.A. Prediction of cardiac events after uncomplicated myocardial infarction: a prospective study comparing predischarge exercise thallium-201 scintigraphy and coronary angiography. United States: N. p., 1983. Web. doi:10.1161/01.CIR.68.2.321.
Gibson, R.S., Watson, D.D., Craddock, G.B., Crampton, R.S., Kaiser, D.L., Denny, M.J., & Beller, G.A. Prediction of cardiac events after uncomplicated myocardial infarction: a prospective study comparing predischarge exercise thallium-201 scintigraphy and coronary angiography. United States. doi:10.1161/01.CIR.68.2.321.
Gibson, R.S., Watson, D.D., Craddock, G.B., Crampton, R.S., Kaiser, D.L., Denny, M.J., and Beller, G.A. Mon . "Prediction of cardiac events after uncomplicated myocardial infarction: a prospective study comparing predischarge exercise thallium-201 scintigraphy and coronary angiography". United States. doi:10.1161/01.CIR.68.2.321.
@article{osti_5022041,
title = {Prediction of cardiac events after uncomplicated myocardial infarction: a prospective study comparing predischarge exercise thallium-201 scintigraphy and coronary angiography},
author = {Gibson, R.S. and Watson, D.D. and Craddock, G.B. and Crampton, R.S. and Kaiser, D.L. and Denny, M.J. and Beller, G.A.},
abstractNote = {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.},
doi = {10.1161/01.CIR.68.2.321},
journal = {Circulation; (United States)},
number = ,
volume = 68:2,
place = {United States},
year = {1983},
month = {8}
}