Prognostic value of thallium-201 exercise scintigraphy in low-risk patients after Q-wave myocardial infarction: comparison with exercise testing and catheterization.
In a prospective study of 100 consecutive patients discharged after a Q-wave myocardial infarction, the value of reversible ischemia on thallium-201 scintigraphy to assess the risk of cardiac events (death or reinfarction) during 4 years was compared with variables from exercise testing and cardiac catheterization. Patients with markedly impaired left ventricular function [ejection fraction (EF) < or = 0.30] were excluded. During follow-up there were 20 cardiac events (10 cardiac deaths and 10 reinfarctions). Thallium-201 scintigraphy was significantly better than all exercise test variables and better than an EF < 0.40, with good sensitivity and specificity (75 and 51%, respectively). Exercise-induced reversible ischemia on scintigraphy yielded the same information as the presence of multivessel disease. Exercise test variables were of limited value to assess prognosis. Thus, thallium-201 scintigraphy can be used as the only tool to predict future cardiac events in low-risk patients after a Q-wave myocardial infarction.
de Cock
C C
CC
Department of Cardiology, Free University Hospital, Amsterdam, The Netherlands.
Visser
F C
FC
Van Eenige
M J
MJ
Bezemer
P D
PD
Roos
J C
JC
Roos
J P
JP
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D002302:Cardiac Output / Q000502:physiology; D017023:Coronary Angiography; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D015637:Gated Blood-Pool Imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000401:mortality; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes