Prognostic utility of intravenous dipyridamole thallium-201 imaging and exercise testing after an acute infarction
To define the prognosis in asymptomatic survivors of acute infarcts (MI), coronary vasodilation was induced with I.V. dipyridamole, followed by Thallium-201 (T1) imaging in 26 patients just prior to discharge. All patients (pts) also had a modified exercise treadmill (MET) test. During the imaging protocol, 10 (39%) pts experienced transient adverse effects and 12 (46%) pts had either angina or ST depression with MET. During a mean follow-up of 17 months, 13 (50%) pts had a cardiac event defined as readmission for control of angina, MI or death. In the 13 pts having cardiac events, 4 (31%) had ST depression and 2 (15%) had angina during MET, but 12 (92%) demonstrated T1 redistribution (RD) as determined by at least 1 segment/scan having a transient defect. A logistic regression analysis using several exercise, scintigraphic and general clinical parameters, showed that the presence of T1 RD was the only significant (p <0.001) predictor for future cardiac events. The predicted probability for events in pts with T1 RD was 80 +- 10% (SD) and was 9 +- 9% in those without T1 RD. The mean number of defects per scan was similar in pts with and without cardiac events, but compared to persistent defects, transient ones are associated with potentially ischemic myocardium. Although the pt population is relatively small, dipyridamole T1 imaging after MI appears to be safe and has demonstrated prognostic value. It also offers an alternative and/or addition to exercise testing in the predischarge evaluation after acute MI.
- Research Organization:
- Boston City Hospital, Boston Univ. School of Medicine, Boston, MA
- OSTI ID:
- 6933538
- Report Number(s):
- CONF-840619-
- Journal Information:
- J. Nucl. Med.; (United States), Journal Name: J. Nucl. Med.; (United States) Vol. 25:5; ISSN JNMEA
- Country of Publication:
- United States
- Language:
- English
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62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DEATH
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DIAGNOSTIC USES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
EXERCISE
HEART
HEAVY NUCLEI
IMAGE PROCESSING
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MUSCLES
MYOCARDIAL INFARCTION
MYOCARDIUM
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
PROCESSING
RADIOISOTOPE SCANNING
RADIOISOTOPES
SAFETY
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
THALLIUM 201
THALLIUM ISOTOPES
USES