Predictive value of planar 18F-fluorodeoxyglucose imaging for cardiac events in patients after acute myocardial infarction.
This long-term study examines the predictive value of planar myocardial 18F-fluorodeoxyglucose (FDG) imaging for cardiac events after acute myocardial infarction (AMI). From December 1989 to April 1991, 59 consecutive patients with AMI had undergone planar rest thallium-201 (Tl-201)/FDG imaging for viability assessment; 53 (42 men) were included in this study. Mean follow-up was 47 +/- 15 months. Cardiac events were defined as cardiac-related death, reinfarction, late revascularization, and unstable angina pectoris. A mismatch pattern was defined as a FDG uptake exceeding Tl-201 uptake by > or = 20%. A concordant reduction in flow and metabolism was defined as a match. In the mismatch group (n = 39) were 19 events versus 1 event in the match group (n = 14) (p <0.009). In the mismatch group were 5 cardiac deaths, 3 reinfarctions, 7 late revascularizations, and 4 patients had unstable angina pectoris. There was 1 cardiac death in the match group. The event-free rate estimated using Kaplan Meier curves for patients with and without a mismatch was significantly different (p = 0.018). The relative risk for patients with a mismatch for developing a future cardiac event was estimated at 7.8 versus patients with a match. Thus, planar myocardial FDG imaging shortly after AMI has important prognostic significance for prediction of future cardiac events. Patients with a mismatch shortly after AMI have a high risk for future cardiac events on medical therapy.
Huitink
J M
JM
Department of Anesthesiology, Amsterdam Medical Center, The Netherlands.
Visser
F C
FC
Bax
J J
JJ
van Lingen
A
A
Groenveld
A B
AB
Teule
G J
GJ
Visser
C A
CA
D000368:Aged; D006328:Cardiac Catheterization; D017352:Echo-Planar Imaging; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes
D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; D019788:Fluorodeoxyglucose F18