| Prognostic value of exercise 201Tl tomography in patients treated with thrombolytic therapy during acute myocardial infarction. | |
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MedLine Citation:
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PMID: 8941097 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Although myocardial perfusion scintigraphy is of proven value in the risk stratification of patients with a recent myocardial infarction who receive conventional therapy, its value in patients undergoing thrombolytic therapy remains controversial. METHODS AND RESULTS: Seventy-one patients who received thrombolytic therapy for acute myocardial infarction had exercise 201Tl tomography and coronary angiography before hospital discharge. Eleven (15%) of 71 patients had ischemic ST-segment depression during exercise, whereas 27 patients (38%) had scintigraphic ischemia. Twenty-five (37%) of 68 patients had a cardiac event consisting of either death (n = 2), recurrent myocardial infarction (n = 5), congestive heart failure (n = 7), or unstable angina (n = 11) during a follow-up of 26 +/- 18 months. Univariate predictors of cardiac events were as follows: Killip class (P = .04); left ventricular ejection fraction (P < .0005); total (P = .002) and ischemic (P < .0005) perfusion defect size; percent thallium lung uptake (P = .001); presence of infarct-zone redistribution (P = .02); and multivessel coronary artery disease (P = .01). By multivariate analysis, the significant joint predictors of risk were ejection fraction (P < .0005) and ischemic perfusion defect size (P = .005). The combination of ejection fraction and thallium tomography added significant incremental prognostic information to the clinical data, whereas angiography did not further improve a model that included clinical, ejection fraction, and tomographic variables. CONCLUSIONS: Quantitative exercise 201Tl tomography provides important incremental, long-term prognostic information in patients receiving thrombolytic therapy for acute myocardial infarction. |
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Authors:
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H A Dakik; J J Mahmarian; K T Kimball; M G Koutelou; R Medrano; M S Verani |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Circulation Volume: 94 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1996 Dec |
Date Detail:
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Created Date: 1997-01-02 Completed Date: 1997-01-02 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 2735-42 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Baylor College of Medicine, Houston, Tex, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Coronary Angiography Exercise* Exercise Test Female Heart Diseases Humans Male Middle Aged Multivariate Analysis Myocardial Infarction / drug therapy*, physiopathology, radiography* Prognosis Risk Factors Sensitivity and Specificity Stroke Volume Thallium Radioisotopes / diagnostic use* Thrombolytic Therapy* Tomography, Emission-Computed, Single-Photon* |
| Chemical | |
Reg. No./Substance:
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0/Thallium Radioisotopes |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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