Predicting late restenosis after coronary angioplasty by very early (12 to 24 h) thallium-201 scintigraphy: Implications with regard to mechanisms of late coronary restenosis

Journal Article · Fri Jun 01 00:00:00 EDT 1990 · Journal of the American College of Cardiology; (USA)

DOI:https://doi.org/10.1016/0735-1097(90)92815-J· OSTI ID:7063443

Hardoff, R; Shefer, A; Gips, S; Merdler, A; Flugelman, M Y; Halon, D A; Lewis, B S ^[1]

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1. Lady Davis Carmel Hospital, Haifa (Israel)

To examine whether late coronary restenosis may be predicted by abnormalities of myocardial perfusion in the early hours after successful percutaneous transluminal coronary angioplasty and to study in greater detail the mechanisms involved in the development of late coronary restenosis after angioplasty, a prospective study was undertaken in 90 consecutive patients. Thallium-201 scintigrams were recorded at rest and during the stress of atrial pacing, 12 to 24 h after angioplasty, and the results were related to the findings at angiography in 70 patients undergoing late cardiac catheterization. A reversible thallium-201 perfusion defect was found in 39 (38%) of 104 myocardial regions supplied by the dilated coronary vessel and identified a subset of patients at high risk of late (6 to 12 months) angiographic restenosis (sensitivity 77%, specificity 67%). In contrast, late coronary restenosis developed in only 7 (11%) of 65 vessels and in 5 (14%) of 37 patients with a nonischemic thallium-201 scintigram on day 1 (p less than 0.005). Multivariate logistic regression analysis of 14 possible preangioplasty and periangioplasty clinical and angiographic variables selected reversible perfusion defect on the thallium-201 scintigram on day 1 (p = 0.016) and immediate postangioplasty residual coronary narrowing (p = 0.004) as significant independent predictors of late restenosis, with younger patient age as an additional less powerful predictor (p less than 0.05). The findings have important implications regarding the pathogenesis of late coronary restenosis in patients undergoing successful angioplasty and they imply that in the majority of these patients pathophysiologic events in the early minutes and hours after angioplasty may determine the development of late restenosis.

• OSTI ID: 7063443
• Journal Information: Journal of the American College of Cardiology; (USA), Vol. 15:7; ISSN 0735-1097
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARDIOVASCULAR DISEASES
DIAGNOSIS
MYOCARDIUM
SCINTISCANNING
CORONARIES
MAN
MULTIVARIATE ANALYSIS
PATIENTS
PERFUSED TISSUES
REGRESSION ANALYSIS
SURGERY
THALLIUM 201
ANIMAL TISSUES
ANIMALS
ARTERIES
BETA DECAY RADIOISOTOPES
BLOOD VESSELS
BODY
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MAMMALS
MATHEMATICS
MEDICINE
MUSCLES
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PRIMATES
RADIOISOTOPE SCANNING
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
STATISTICS
THALLIUM ISOTOPES
TISSUES
VERTEBRATES
550601* - Medicine- Unsealed Radionuclides in Diagnostics