Document Detail


Acute rest perfusion imaging in high risk unstable angina: association with troponin T and clinical endpoints.
MedLine Citation:
PMID:  14690190     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Troponin T (TnT) and rest perfusion imaging (RPI) have been reported to be important diagnostic tools for risk stratification in patients with chest pain. METHODS: We investigated the association between two methods in 60 patients presenting with typical chest pain at rest within the last 6 h before admission. All patients underwent Tc-99m gated SPECT imaging and serial TnT measurements and were followed for occurrence of adverse cardiac events up to 30 days. RESULTS: Perfusion defect was detected in 42 patients and elevated TnT was observed in 23 patients. All of the patients with an elevated TnT have also perfusion defect in RPI. Half of the patients with normal TnT level (51%) presented a perfusion defect detected by RPI (p = NS). The patients with elevated TnT levels had more perfusion defect numbers than those with normal TnT levels (8.2 +/- 2.9 vs. 5.3 +/- 2.2; p = 0.0007). Cardiac events occurred in 38 patients (14 MI, 24 revascularisation). In predicting cardiac events, RPI and TnT had sensitivities (97 vs. 58%; p < 0.001), specificities (77 vs. 95%, p = NS), positive predictive values (PPV) (88 vs. 96%; p = NS) and negative predictive values (NPV) (94% vs. 57%; p = NS), respectively. In predicting MI, the two tests had sensitivities (93 vs. 93%; p = NS), specificities (37 vs. 78%; p < 0.001), PPVs (31 vs. 57%; p = NS) and NPVs (94 vs. 97%; p = NS), respectively. CONCLUSIONS: These results suggest that in patients with rest angina (1) TnT elevation is associated with the extent of myocardial perfusion defect; (2) both tests are valuable, while positive RPI is more sensitive in predicting all cardiac events irrespective of TnT; both positive TnT and positive RPI predict a high probability to have MI; (3) both negative test results predict a very low probability to have cardiac event, including MI.
Authors:
M Hakan Dinckal; Nur Aksoy; Mehmet Aksoy; Vedat Davutoglu; Nurten Dinckal; Serdar Soydinc; Ilyas Akdemir
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The international journal of cardiovascular imaging     Volume:  19     ISSN:  1569-5794     ISO Abbreviation:  Int J Cardiovasc Imaging     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-23     Completed Date:  2004-04-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100969716     Medline TA:  Int J Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  511-7     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey. mhdinckal@gantep.edu.tr
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MeSH Terms
Descriptor/Qualifier:
Angina, Unstable / blood*,  radionuclide imaging*,  therapy
Angioplasty, Transluminal, Percutaneous Coronary
Chi-Square Distribution
Female
Humans
Male
Middle Aged
Myocardial Infarction / prevention & control
Predictive Value of Tests
ROC Curve
Sensitivity and Specificity
Statistics, Nonparametric
Tomography, Emission-Computed, Single-Photon*
Troponin T / blood*
Chemical
Reg. No./Substance:
0/Troponin T

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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