title: Dipyridamole thallium-201 imaging very early after uncomplicated acute myocardial infarction in patients treated with thrombolytic therapy.
abstract: The aim of this study was to assess the safety and prognostic value of dipyridamole 201T1 imaging very early after acute myocardial infarction in patients treated with thrombolytic therapy. Fifty-two consecutive patients with an uncomplicated clinical course underwent quantitative planar dipyridamole 201T1 imaging 2 5 days after acute myocardial infarction. The patients were followed for 14 +/- 7 months after discharge. No major complications occurred during the test. Of the 30 patients with redistribution, five (16.6%) developed in-hospital unstable angina as against none of the 22 patients without redistribution. During follow-up, a total of live late cardiac events were observed: two deaths and two cases of unstable angina in the group with reversible defects and one reinfarction in the group with fixed defects. The 1-year actuarial probability of being free of cardiac events was, respectively, 66 +/- 10% and 94 +/- 5% in the patients with and without redistribution (P < 0.01). In conclusion, in patients treated with thrombolysis, dipyridamole-201T1 imaging very early after uncomplicated acute myocardial infarction is a feasible and safe test. Patients with fixed defects appear to be at low risk and may be candidates for early discharge; the presence of redistribution identifies a subgroup of patients who may benefit from further careful clinical evaluation.
authors.affiliation: I Division of Cardiology A. De Gasperis Niguarda Hospital, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Pirelli
authors.forename: A
authors.initials: A
authors.lastname: Moreo
authors.forename: G
authors.initials: G
authors.lastname: Piccalo
authors.forename: A
authors.initials: A
authors.lastname: Corato
authors.forename: R
authors.initials: R
authors.lastname: Sara
authors.forename: G B
authors.initials: GB
authors.lastname: Danzi
authors.forename: E
authors.initials: E
authors.lastname: Corrada
authors.forename: D
authors.initials: D
authors.lastname: Massa
authors.forename: C
authors.initials: C
authors.lastname: De Vita
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D017023:Coronary Angiography / Q000379:methods; D004176:Dipyridamole; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D016016:Proportional Hazards Models; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes; D015912:Thrombolytic Therapy; D014665:Vasodilator Agents
chemical_list: D013794:Thallium Radioisotopes; D014665:Vasodilator Agents; D004176:Dipyridamole