Document Detail

Comparison of coronary angiography and early oral dipyridamole thallium-201 scintigraphy in patients receiving thrombolytic therapy for acute myocardial infarction.
MedLine Citation:
PMID:  2220536     Owner:  NLM     Status:  MEDLINE    
We evaluated 50 consecutive patients who received thrombolytic therapy for acute myocardial infarction using thallium-201 single photon emission computed tomography in combination with oral dipyridamole (300 mg) to assess the frequency of residual myocardial ischemia. Thallium studies were performed early after myocardial infarction at a mean of 4.6 days (range 3 to 11) in 50 patients. The time from the onset of chest pain to the administration of thrombolytic therapy was 2.6 hours (range 0.5 to 5.5). Q wave myocardial infarction was evident in 46 patients; four patients had a non-Q wave infarction (anterior infarction in 31 patients and inferior infarction in 19 patients). The serum mean peak creatinine kinase was 1503 IU/L (range 127 to 6500). Coronary angiography was performed in all patients at a mean of 3.1 days (range 2 to 10) and revealed the infarct-related vessel to be patent in 36 patients (72%). The ejection fraction was 48% (range 26% to 67%). After dipyridamole administration, 13 patients (26%) developed angina that was easily reversed with the administration of intravenous aminophylline. Systolic blood pressure decreased from 122 to 115 mm Hg (p less than 0.05) and the heart rate increased from 76 to 85 beats/min (p less than 0.05). None of the patients had significant hypotension, arrhythmias, or evidence of infarct extension. Perfusion abnormalities were present on the initial thallium images in 48 patients. Redistribution suggestive of ischemia was present in 36 patients (72%). Ischemia confined to the vascular distribution of the infarct vessel was evident in 22 patients. Seven patients had ischemia in the infarct zone as well as in a remote myocardial segment. Thus 29 patients (58%) had ischemia in the distribution of the infarct vessel. Ischemia in the infarct zone was evident in 19 of 36 patients (53%) with open infarct vessels and in 10 of 14 patients (71%) with occluded infarct vessels. In conclusion, thallium-201 single photon emission computed tomography using oral dipyridamole was safely performed in patients with recent myocardial infarctions who receive thrombolytic therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
A Jain; R R Hicks; G H Myers; J J McCarthy; J R Perry; K F Adams
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American heart journal     Volume:  120     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1990 Oct 
Date Detail:
Created Date:  1990-11-05     Completed Date:  1990-11-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  839-47     Citation Subset:  AIM; IM    
Division of Cardiology, University of North Carolina Hospital, Chapel Hill 27514.
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MeSH Terms
Angina Pectoris / etiology
Coronary Angiography*
Dipyridamole / administration & dosage,  adverse effects,  diagnostic use*
Heart Catheterization
Middle Aged
Myocardial Infarction / diagnosis,  drug therapy*
Thallium Radioisotopes / diagnostic use
Thrombolytic Therapy*
Tomography, Emission-Computed, Single-Photon / adverse effects,  methods*
Grant Support
Reg. No./Substance:
0/Thallium Radioisotopes; 58-32-2/Dipyridamole

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