Article Text

Download PDFPDF
Dipyridamole thallium-201 scintigraphy for early risk stratification of patients after uncomplicated myocardial infarction
  1. Joseph Hunga,
  2. Mehdi Moshiric,
  3. Geoffrey N Groomd,
  4. Agatha A Van der Schaafd,
  5. Richard W Parsonsb,
  6. Mark E Handsc
  1. aDepartment of Medicine, University of Western Australia, Perth, Australia, bDepartment of Public Health, cDepartment of Cardiovascular Medicine, Sir Charles Gairdner Hospital, Perth, Australia, dDepartment of Nuclear Medicine
  1. Dr Hung, University Department of Medicine, QE II Medical Centre, Nedlands, Perth, WA 6009, Australia. email: jhung{at}


Objective To determine the safety and prognostic value of dipyridamole thallium-201 scintigraphy performed in patients within three to five days of acute myocardial infarction, including those receiving thrombolytic treatment.

Design A prospective study of dipyridamole thallium-201 scintigraphy in patients early after acute myocardial infarction.

Setting University hospital.

Patients 200 patients who were clinically uncomplicated at day 3 after infarction, 92 (46%) of whom had received thrombolysis.

Main outcome measures Incidence of cardiac death, non-fatal reinfarction, readmission to hospital for unstable angina, or non-elective revascularisation procedure within six months’ follow up.

Results No patient had a serious complication from the dipyridamole study. At six month follow up, 55 patients (28%) had suffered a defined cardiac event. Patients who received thrombolysis had the same extent of thallium-201 redistribution and the same occurrence of subsequent cardiac events as those not receiving thrombolysis. Patients who subsequently had an event had more myocardial segments showing thallium-201 redistribution than event free patients: 2.7 (SD 1.9) v 1.2 (1.4), respectively (p < 0.001). Among all clinical and scintigraphic variables, multivariate analysis identified the extent of thallium-201 redistribution as the only independent predictor of outcome (p < 0.001). Among 63 patients (32%) of the study cohort who showed more than two myocardial segments with thallium-201 redistribution, the adjusted risk ratio for a cardiac event was 7.5 (95% confidence interval 2.9 to 19.1) compared with patients without any redistribution.

Conclusions Dipyridamole thallium-201 scintigraphy can be performed safely within a few days of the event in patients with uncomplicated myocardial infarction, including those who received thrombolysis, and can identify a subgroup of patients at high risk of future ischaemic events.

  • dipyridamole
  • thallium
  • myocardial infarction
  • prognosis

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.