Incremental prognostic value of thallium reinjection after stress-redistribution imaging in patients with previous myocardial infarction and left ventricular dysfunction.
This study evaluated the incremental prognostic value of 201TI reinjection imaging over clinical, exercise and thallium stress-redistribution data in patients with previous myocardial infarction and left ventricular dysfunction.


METHODS
Thallium-201 reinjection after stress-redistribution SPECT was performed in 104 consecutive patients with a first Q-wave myocardial infarction (> 8 wk) and left ventricular ejection fraction < or = 40%. Follow-up data (mean 22 mo) were available for 98 patients; 16 patients underwent early revascularization procedures within 3 mo after exercise testing and were not considered for the analysis.


RESULTS
During follow-up there were 13 hard events (cardiac death and myocardial infarction) and 11 soft events (coronary revascularization procedures > 3 mo after thallium imaging). With multivariate Cox regression analysis, the sum of defects at stress-redistribution imaging that were reversible or moderate irreversible after reinjection was a powerful predictor of subsequent events. The addition of thallium reinjection imaging data significantly improved the prognostic power of clinical, exercise and stress-redistribution data for the occurrence of hard events (p < 0.01).


CONCLUSIONS
In patients with previous myocardial infarction and left ventricular dysfunction, thallium reinjection imaging provides incremental prognostic information over those obtained from conventional stress-redistribution imaging.
Petretta
M
M
Institute of Internal Medicine, Cardiology and Heart Surgery, University of Naples, Italy.
Cuocolo
A
A
Bonaduce
D
D
Nicolai
E
E
Cardei
S
S
Berardino
S
S
Ianniciello
A
A
Apicella
C
C
Bianchi
V
V
Salvatore
M
M
D000704:Analysis of Variance; D005080:Exercise Test; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D016019:Survival Analysis; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*
D013794:Thallium Radioisotopes