Relative prognostic value of rest thallium-201 imaging, radionuclide ventriculography and 24 hour ambulatory electrocardiographic monitoring after acute myocardial infarction

Journal Article · Wed Jul 01 00:00:00 EDT 1987 · J. Am. Coll. Cardiol.; (United States)

DOI:https://doi.org/10.1016/S0735-1097(87)80155-9· OSTI ID:6243532

Hakki, A H; Nestico, P F; Heo, J; Unwala, A A; Iskandrian, A S

Rest thallium-201 scintigraphy, radionuclide ventriculography and 24 hour Holter monitoring are acceptable methods to assess myocardial necrosis, performance and electrical instability. This study examined the relative value of the three tests, when obtained a mean of 7 days after acute myocardial infarction, in predicting 1 year mortality in 93 patients. Planar thallium-201 images were obtained in three projections and were scored on a scale of 0 to 4 in 15 segments (normal score = 60). Patients were classified as having high risk test results as follows: thallium score less than or equal to 45 (33 patients), left ventricular ejection fraction less than or equal to 40% (51 patients) and complex ventricular arrhythmias on Holter monitoring (36 patients). During the follow-up of 6.4 +/- 3.4 months (mean +/- SD), 15 patients died of cardiac causes. All three tests were important predictors of survival by univariate Cox survival analysis; the thallium score, however, was the only important predictor by multivariate analysis. The predictive power of the thallium score was comparable with that of combined ejection fraction and Holter monitoring (chi-square = 21 versus chi-square = 22). Thus, rest thallium-201 imaging performed before hospital discharge provides important prognostic information in survivors of acute myocardial infarction which is comparable with that provided by left ventricular ejection fraction and Holter monitoring. Patients with a lower thallium score (large perfusion defects) are at high risk of cardiac death during the first year after infarction.

• Research Organization: Hahnemann Univ., Philadelphia, PA
• OSTI ID: 6243532
• Journal Information: J. Am. Coll. Cardiol.; (United States), Journal Name: J. Am. Coll. Cardiol.; (United States) Vol. 10:1; ISSN JACCD
• Country of Publication: United States
• Language: English

Related Subjects

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