Ability of dipyridamole-thallium-201 imaging one to four days after acute myocardial infarction to predict in-hospital and late recurrent myocardial ischemic events

Journal Article · Mon Jan 15 04:00:00 EST 1990 · American Journal of Cardiology; (USA)

DOI:https://doi.org/10.1016/0002-9149(90)90078-F· OSTI ID:7244521

Brown, K A; O'Meara, J; Chambers, C E; Plante, D A ^[1]

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1. Univ. of Vermont College of Medicine, Burlington (USA)

The ability of dipyridamole-thallium-201 imaging to predict in-hospital and late cardiac events when performed very early (62 +/- 21 hours, range 23 to 102) after acute myocardial infarction (AMI) was tested in 50 patients. During hospitalization, 1 patient developed recurrent AMI and 8 patients developed recurrent angina after MI associated with ST-segment depression at 60 +/- 42 hours after the dipyridamole-thallium-201 imaging; of these, 6 required urgent coronary revascularization. No patient died in-hospital. There were no serious adverse effects during the dipyridamole protocol. Using stepwise multivariate logistic regression analysis, the best and only statistically significant predictor of in-hospital ischemic cardiac events was the presence of thallium-201 redistribution within the infarct zone (p = 0.0001). Of 20 patients with infarct zone thallium-201 redistribution, 9 (45%) developed in-hospital ischemic cardiac events compared to 0 of 30 patients without infarct zone thallium-201 redistribution (p less than 0.0001). During a follow-up 12 +/- 7 months after discharge, 3 additional patients with infarct zone thallium-201 redistribution developed recurrent AMI or unstable angina, whereas no patient without infarct zone thallium-201 redistribution developed ischemic cardiac events. These data suggest that dipyridamole-thallium-201 imaging performed very early after AMI may identify a subgroup of patients at high risk for in-hospital and late ischemic cardiac events. Such patients may benefit from early cardiac catheterization and revascularization. Patients without infarct zone thallium-201 redistribution appear to be at very low risk for in-hospital and late ischemic cardiac events and may be candidates for early discharge.

• OSTI ID: 7244521
• Journal Information: American Journal of Cardiology; (USA), Journal Name: American Journal of Cardiology; (USA) Vol. 65:3; ISSN 0002-9149; 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
BODY
CARDIOVASCULAR AGENTS
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DIAGRAMS
DISEASES
DISTRIBUTION
DRUGS
ELECTROCARDIOGRAMS
ELECTRON CAPTURE RADIOISOTOPES
HEART
HEAVY NUCLEI
ISCHEMIA
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MATHEMATICS
MULTIVARIATE ANALYSIS
MYOCARDIAL INFARCTION
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
REGRESSION ANALYSIS
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
STATISTICS
THALLIUM 201
THALLIUM ISOTOPES
TISSUE DISTRIBUTION
VASCULAR DISEASES
VASODILATORS