Prognostic value of an increase in fluorine-18 deoxyglucose uptake in patients with myocardial infarction: comparison with stress thallium imaging.
OBJECTIVE
This study was undertaken to evaluate the prognostic value of an increase in fluorine (F)-18 deoxyglucose uptake compared with clinical, angiographic and stress thallium findings in patients with myocardial infarction.


BACKGROUND
Positron emission tomography (PET) imaging using F-18 deoxyglucose has been applied to assess tissue viability in patients with coronary artery disease. We hypothesized that patients with a myocardial segment with augmented F-18 deoxyglucose uptake are at high risk for a future cardiac event.


METHODS
One hundred fifty-eight consecutive patients with myocardial infarction referred for F-18 deoxyglucose PET and stress thallium scans were studied. Follow-up was obtained in 84 patients at a mean interval of 23 months to investigate prognostic implications of radionuclide studies.


RESULTS
Seventeen patients had a cardiac event during the follow-up interval. Univariate analysis showed that an increase in F-18 deoxyglucose uptake was the best predictor of a future cardiac event (p = 0.0006), followed by the number of stenosed vessels (p = 0.008). In the multivariate analysis, when an increase in F-18 deoxyglucose uptake was entered into the model, only angiographic variables had an independent prognostic value, whereas no other radionuclide variables showed significant prognostic value. Among patients who did not show redistribution, a future cardiac event was observed more often in patients with than in those without an increase in F-18 deoxyglucose uptake (p < 0.05).


CONCLUSIONS
Thus, an increase in F-18 deoxyglucose uptake seemed to be the best predictor of a future cardiac event among all clinical, angiographic and radionuclide variables in this study of stable patients with myocardial infarction. Even when a stress thallium-201 scan does not show redistribution, those patients who have an increase in F-18 deoxyglucose uptake in a PET study may be at risk for a future cardiac event, and these patients may need aggressive treatment to prevent a future cardiac event.
Tamaki
N
N
Department of Nuclear Medicine, Kyoto University Faculty of Medicine, Japan.
Kawamoto
M
M
Takahashi
N
N
Yonekura
Y
Y
Magata
Y
Y
Nohara
R
R
Kambara
H
H
Sasayama
S
S
Hirata
K
K
Ban
T
T
D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003847:Deoxyglucose / Q000031:analogs & derivatives* / Q000378:metabolism; D005080:Exercise Test; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000378:metabolism; D011379:Prognosis; D013794:Thallium Radioisotopes; D014055:Tomography, Emission-Computed
D005462:Fluorine Radioisotopes; D013794:Thallium Radioisotopes; D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose