title: Dual radionuclide single-photon emission computed tomography in the prediction of further ischemic risk after acute myocardial infarction.
abstract: To evaluate whether the findings of dual single-photon emission computed tomography (SPECT) with technetium-99m pyrophosphate (Tc-99m PPi) and thallium-201 were predictive of further cardiac events in their hospital course, we studied 130 patients recovering from acute myocardial infarction (AMI). Fifty-four patients showed overlapping of Tc-99m PPi and thallium-201 in the same location (overlap positive group), and 76 patients had no overlap (overlap negative group). Of the 130 patients, 36 (28%) had a cardiac event. In patients in the overlap positive group, the incidence of subsequent events was significantly higher than in patients in the overlap negative group (44% versus 16%; p < 0.001). In the overlap positive group, the Tc-99m PPi uptake score and the number of overlap segments in patients with further events was significantly higher than those in patients without further events (10.2 +/- 5.1 versus 6.4 +/- 4.1, p < 0.005 and 5.2 +/- 2.0 versus 3.3 +/- 1.3, p < 0.001, respectively). These results suggest that patients who have a Tc-99m PPi and thallium-201 overlap negative scan can be candidates for early hospital discharge. In contrast, patients who have a greater number of overlap segments may require early catheterization and revascularization, so that simultaneous SPECT imaging Tc-99m PPi and thallium-201 might be useful for identifying patients with further ischemic risk after AMI in their hospital course.
authors.affiliation: Department of Radiology, Fujieda Municipal Hospital, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Isoda
authors.forename: Y
authors.initials: Y
authors.lastname: Itagaki
authors.forename: N
authors.initials: N
authors.lastname: Nomura
authors.forename: T
authors.initials: T
authors.lastname: Urushida
authors.forename: A
authors.initials: A
authors.lastname: Naitou
authors.forename: A
authors.initials: A
authors.lastname: Watanabe
authors.forename: S
authors.initials: S
authors.lastname: Takayama
authors.forename: M
authors.initials: M
authors.lastname: Imamura
authors.forename: S K
authors.initials: SK
authors.lastname: Ha-Kawa
authors.forename: T
authors.initials: T
authors.lastname: Murata
authors.forename: Y
authors.initials: Y
authors.lastname: Nakano
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging*; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology; D011379:Prognosis; D019275:Radiopharmaceuticals; D016698:Technetium Tc 99m Pyrophosphate; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; D016698:Technetium Tc 99m Pyrophosphate