Exercise thallium-201 scintigraphy after thrombolytic therapy with or without angioplasty for acute myocardial infarction

doi:10.1016/0002-9149(93)90536-L

The American Journal of Cardiology

Volume 71, Issue 15, 1 June 1993, Pages 1257-1261

https://doi.org/10.1016/0002-9149(93)90536-L Get rights and content

Abstract

Scant data are available concerning the application and results of exercise thallium-201 (TI-201) scintigraphy after acute myocardial infarction (AMI) treated with thrombolytic therapy. The goals of this study were to determine the ability of exercise TI-201 scintigraphy to detect inducible ischemia and to identify multivessel coronary artery disease (CAD) in 88 consecutive postinfarction patients who received thrombolytic therapy and underwent both predischarge noninvasive testing and coronary angiography. Exercise-induced TI-201 redistribution on quantitative scintigraphy was significantly more prevalent than exercise ST-segment depression (48 vs 14%, p < 0.001). Sensitivity and specificity of exercise ST depression alone for identification of multivessel disease was 29 and 96%, respectively. Sensitivity of a remote TI-201 defect for muttivessel CAD detection was 35 and 87%, respectively — not significantly different from values for ST depression alone. When considered as a single variable, the presence of either ST depression or a remote TI-201 defect was associated with a 58% sensitivity (p < 0.05, compared with either ST depression or TI-201 redistribution alone), but a somewhat diminished specificity of 78%. There was no difference in extent or severity of angiographic CAD in patients with muttivessel CAD with or without inducible ischemia. In conclusion, this study shows that exercise TI-201 imaging is more sensitive than exercise ST depression for detection of residual ischemia during submaximal exercise in patients who received thrombolytic therapy for AMI. The combination of the presence of either TI-201 redistribution or ischemic ST depression was better than either variable alone for identifying patients with multivessel CAD.

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^☆: This study was supported in part by Grant R01-HL-26205 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.

¹: Dr. Haber is a Research Fellow of the American Heart Association, Virginia Affiliate (1991–1992).

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Exercise thallium-201 scintigraphy after thrombolytic therapy with or without angioplasty for acute myocardial infarction☆

Abstract

Am J Cardiol

Am J Cardiol

Am J Cardiol

Am J Cardiol

Am Heart J

Am Heart J

Am J Cardiol

J Am Coll Cardiol

Am Heart J

Am J Cardiol

J Am Coll Cardiol

Am J Cardiol

Am J Med

Prediction of cardiac events after uncomplicated myocardial infarction: a prospective study comparing predischarge exercise thallium-201 scintigraphy and coronary angiography

Circulation