Usefulness of early positive technetium-99m stannous pyrophosphate scan in predicting reperfusion after thrombolytic therapy for acute myocardial infarction

Journal Article · Thu Dec 31 23:00:00 EST 1987 · Am. J. Cardiol.; (United States)

DOI:https://doi.org/10.1016/0002-9149(88)91296-9· OSTI ID:5470963

Manyari, D E; Thompson, C R; Duff, H J; Knudtson, M L; Kloiber, R; Smith, E R; Belenkie, I

To test the hypothesis that scans with technetium-99m pyrophosphate (Tc-99m-PPi) are positive when performed early after successful thrombolytic therapy for acute myocardial infarction (AMI), 16 consecutive patients with AMI who received thrombolytic therapy within 5 hours after the onset of chest pain were studied. Patients were included if chest pain lasted for greater than 30 minutes, was unresponsive to sublingual nitroglycerin and was associated with at least 0.2 mV ST-segment elevation in at least 2 contiguous electrocardiographic leads. All patients received 1.5 million IU of streptokinase intravenously, a mean of 195 +/- 99 minutes after onset of chest pain. Tc-99m-PPi scans and coronary cineangiograms were recorded 491 +/- 156 minutes and 518 +/- 202 minutes, respectively, after the onset of symptoms. Effective reperfusion was present in 10 patients, 6 of whom had positive Tc-99m-PPi scans (sensitivity of 60% to detect reperfusion). Of the 6 patients without effective reperfusion, 3 had positive Tc-99m-PPi scans (specificity of 50%, p greater than 0.05). Analysis of the data using various definitions of effective reperfusion or artery patency yielded similar results. Thus, our findings indicate that early AMI scanning with Tc-99m-PPi does not accurately detect the presence or absence of reperfusion in patients with AMI after treatment with intravenous streptokinase. At this time, coronary cineangiography is the only reliable method to detect reperfusion promptly after thrombolytic therapy.

• Research Organization: Univ. of Calgary, Canada
• OSTI ID: 5470963
• Journal Information: Am. J. Cardiol.; (United States), Journal Name: Am. J. Cardiol.; (United States) Vol. 61:1; ISSN AJCDA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DIAGNOSIS
DISEASES
ENZYMES
HEART
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MYOCARDIAL INFARCTION
NUCLEI
ODD-EVEN NUCLEI
ORGANS
OXYGEN COMPOUNDS
PAIN
PATIENTS
PHOSPHORUS COMPOUNDS
PHOSPHORUS-GROUP TRANSFERASES
PHOSPHOTRANSFERASES
PYROPHOSPHATES
RADIOISOTOPE SCANNING
RADIOISOTOPES
SENSITIVITY ANALYSIS
SYMPTOMS
TECHNETIUM 99
TECHNETIUM ISOTOPES
TRANSFERASES
YEARS LIVING RADIOISOTOPES