Noninvasive evaluation of total occlusion of infarct-related coronary artery after a first myocardial infarction.
Previous studies have demonstrated that the long-term prognosis after acute myocardial infarction in patients whose infarct-related artery remains occluded is worse than that in those with anterograde flow. To determine how to identify patients with occluded infarct-related arteries noninvasively, 143 consecutive patients after a first myocardial infarction underwent exercise testing and dipyridamole thallium scintigraphy. The incidence of total occlusion was higher in inferior/posterior infarction than in anterior infarction (29/53 vs 28/90; p = 0.005). In patients with inferior/posterior infarction, discriminant analysis revealed a sensitivity of 79%, a specificity of 88% and an accuracy of 83% (p = 0.0005) in identifying those with an occluded infarct-related artery. In patients with anterior infarction, the analysis showed a sensitivity of 68%, a specificity of 85% and an accuracy of 79% (p < 0.0001) in identifying those with an occluded artery. These results indicate that noninvasive study may be useful in the evaluation of total occlusion of the infarct-related coronary artery.
Department of Medicine and Geriatrics, Kochi Medical School, Japan.
T
T
Chikamori
Y
Y
Doi
Y
Y
Yonezawa
M
M
Yamada
T
T
Ozawa
D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000209:etiology; D003331:Coronary Vessels; D004176:Dipyridamole; D005069:Evaluation Studies as Topic; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications* / Q000503:physiopathology; D011877:Radionuclide Imaging; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes; D004176:Dipyridamole