Usefulness of dual SPECT with Tc-99m pyrophosphate and Tl-201 to predict further events after acute myocardial infarction with single-vessel coronary artery disease.
OBJECTIVE
This study was undertaken to determine whether the findings of dual SPECT with Tc-99m pyrophosphate (PYP) and Tl-201 were predictive of further cardiac events after acute myocardial infarction.


METHODS
The authors evaluated 88 patients with acute myocardial infarction who underwent dual SPECT for single-vessel coronary artery disease.


RESULTS
Twenty-nine patients showed overlapping of Tc-99m PYP and Tl-201 in the same location (overlap-positive group), and 59 patients had no overlap (overlap-negative group). In patients in the overlap-positive group, the incidence of subsequent events was significantly higher than in patients in the overlap-negative group (P < 0.001). In the overlap-positive group, the number of overlap segments in patients with further events was significantly greater than that in patients without further events (P < 0.005).


CONCLUSIONS
Areas with overlapping of Tc-99m PYP and Tl-201 may contain jeopardized myocardium. These results suggest that patients who have a Tc-99m PYP and Tl-201 overlap-negative scan are a low risk group, whereas patients who have more overlapping segments may require catheterization and revascularization. Thus simultaneous SPECT imaging with Tc-99m PYP and Tl-201 might be useful to identify patients with greater ischemic risk after acute myocardial infarction.
Isoda
H
H
Department of Radiology, Fujieda Municipal Hospital, Kansai Medical University, Moriguchi, Osaka, Japan.
Itagaki
Y
Y
Nomura
N
N
Urushida
T
T
Naitou
A
A
Watanabe
A
A
Takayama
S
S
Nasu
R
R
Uokawa
K
K
Tanaka
Y
Y
D000368:Aged; D000787:Angina Pectoris / Q000209:etiology; D015906:Angioplasty, Balloon, Coronary; D006328:Cardiac Catheterization; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017202:Myocardial Ischemia / Q000209:etiology; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012008:Recurrence; D012307:Risk Factors; D016698:Technetium Tc 99m Pyrophosphate; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes; D016698:Technetium Tc 99m Pyrophosphate