Document Detail


Detection of active left ventricular thrombosis during acute myocardial infarction using indium-111 platelet scintigraphy.
MedLine Citation:
PMID:  6734289     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Platelet scintigraphy with radioactive indium-111 may be used both to identify and to reflect the activity of thrombin in vivo in man. Forty-one patients with acute myocardial infarction were studied for active left ventricular thrombosis by platelet scintigraphy and followed until in-hospital death, discharge, or same-admission cardiac surgery for evidence of systemic embolization. A total of 4.7 +/- 2.4 X 10(9) platelets (mean +/- 1 SD) labelled with 381 mu Ci +/- 51 mu Ci of indium-111 was injected intravenously at 91 +/- 88 hours following the onset of chest pain. Patients were imaged in multiple views on the day of and three to four days after injection of the platelet suspension. Group 1 (n = 29) had transmural myocardial infarctions, of which 21 were anterior (peak total level of creatine phosphokinase [CPK], 2,272 +/- 2,026 IU; mean +/- 1 SD) and eight were inferior (CPK level, 1,673 +/- 589 IU). Group 2 (n = 12) had subendocardial myocardial infarctions (CPK level 799 +/- 751 IU). Those with subendocardial and transmural inferior myocardial infarctions had neither left ventricular thrombosis nor emboli. Ten (48 percent) of 21 with anterior transmural myocardial infarctions had left ventricular thrombosis by platelet scintigraphy. Three with and one without such thrombosis by scintigraphy had acute neurologic episodes. In the group with anterior myocardial infarctions, seven of ten patients with and four of 11 without left ventricular thrombosis received heparin subcutaneously (chi 2 = 1.22 [Yates correction]; p greater than 0.30). We conclude that platelet scintigraphy may be used to monitor antiplatelet and anticoagulant therapy in patients with anterior transmural myocardial infarctions who are at risk for left ventricular thrombosis and systemic embolization.
Authors:
M D Ezekowitz; D J Kellerman; E O Smith; T M Streitz
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Chest     Volume:  86     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1984 Jul 
Date Detail:
Created Date:  1984-08-03     Completed Date:  1984-08-03     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  35-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Platelets / metabolism,  radionuclide imaging*
Coronary Disease / drug therapy,  radionuclide imaging*
Female
Heart Ventricles / radionuclide imaging
Heparin / therapeutic use
Humans
Indium / diagnostic use
Male
Middle Aged
Myocardial Infarction / drug therapy,  radionuclide imaging*
Radioisotopes / diagnostic use
Grant Support
ID/Acronym/Agency:
2 P01 HL 17812-07/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Radioisotopes; 7440-74-6/Indium; 9005-49-6/Heparin

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


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