Comparison of early myocardial technetium-99m pyrophosphate uptake to early peaking of creatine kinase and creatine kinase-MB as indicators of early reperfusion in acute myocardial infarction.
The value of technetium-99m pyrophosphate (Tc-99m-PYP) scintigraphy as an indicator of reperfusion 2.8 to 8 hours after the onset of symptoms of acute myocardial infarction was compared with the value of early peak creatine kinase (CK) and CK-MB release within 16 hours after the onset of symptoms. In 29 patients who received thrombolytic therapy, recanalization was seen (group 1) and in 7 it was not (group 2). In 23 patients (79%) in group 1 scintigraphic findings were positive and in all 7 in group 2 they were negative. In 15 patients (52%) in group 1 and 1 patient (14%) in group 2, CK reached its peak level within 16 hours. In 20 patients (69%) in group 1 and 3 (43%) in group 2 the CK-MB level reached a peak within 16 hours. The sensitivity, specificity and predictive accuracy of positive results of early Tc-99m-PYP scintigraphy in predicting the reperfusion were 79%, 100% and 83%. These values are significantly higher than or similar to those of early peaking of CK and CK-MB release. In contrast to measurements of enzyme release, reperfusion data for Tc-99m-PYP scintigraphy are available immediately after thrombolytic therapy. Therefore, early Tc-99m-PYP scintigraphy (3 to 8 hours after onset of symptoms) is valuable as a noninvasive technique for early diagnosis of reperfusion.
Kondo
M
M
Division of Cardiology, Shimada City Hospital, Shizuoka, Japan.
Yuzuki
Y
Y
Arai
H
H
Shimizu
K
K
Morikawa
M
M
Shimono
Y
Y
D000368:Aged; D000790:Angiocardiography; D002932:Cineangiography; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood*; D011756:Diphosphates; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000201:enzymology*; D009206:Myocardium / Q000201:enzymology*; D011877:Radionuclide Imaging; D013667:Technetium; D016698:Technetium Tc 99m Pyrophosphate; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D011756:Diphosphates; D007527:Isoenzymes; D016698:Technetium Tc 99m Pyrophosphate; D013667:Technetium; D003402:Creatine Kinase; D014568:Urokinase-Type Plasminogen Activator