[Detection of residual myocardial ischemia by Thallium-201 myocardial scintigraphy after myocardial infarction. Apropos of 53 patients treated with thrombolytic agents during the acute phase and with coronary transluminal angioplasty].
The prognosis of silent ischemia after myocardial infarction is similar to that of post-infarction angina. In order to detect this condition two stress myocardial scintigraphies were performed: three weeks after hospital admission for myocardial infarction treated by thrombolytic therapy without any complications or recurrence of chest pain; one month later, after percutaneous transluminal coronary angioplasty on the infarct-related artery in 24 patients or after medical therapy alone when this procedure was not possible (29 patients). Silent ischemia, initially present in two thirds of patients, was less frequently observed in the patients undergoing angioplasty (p < 0.05). In the remaining one third of patients with no silent ischemia, myocardial scintigraphy was unchanged at the follow-up procedure whether or not angioplasty had been performed. These results show that silent ischemia is commonly observed during stress myocardial scintigraphy after acute myocardial infarction treated by thrombolysis, but that this condition can be significantly reduced by coronary angioplasty. When no silent ischemia is observed, coronary angiography and angioplasty do not seem to be indicated.
Hélias
J
J
Service de médecine nucléaire, hôpital G. et R. Laennec, Nantes.
Hazard
J R
JR
Grossetête
R
R
Chevallier
J C
JC
Crochet
D
D
Trochu
J N
JN
Godin
J F
JF
D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011877:Radionuclide Imaging; D013794:Thallium Radioisotopes; D015912:Thrombolytic Therapy
D013794:Thallium Radioisotopes
Appréciation de l'ischémie résiduelle par scintigraphie myocardique au thallium-201, après infarctus du myocarde. A propos de 53 patients traités par thrombolytiques à la phase aiguë et par angioplastie transluminale coronaire.