title: Gated SPECT evaluation of the relationship between admission troponin I, myocardial salvage, and functional recovery in acute myocardial infarction treated by abciximab and early primary angioplasty.
abstract: Using gated SPECT, we evaluated the relationship between admission troponin I, risk area, and myocardial salvage in patients with a first myocardial infarction treated with abciximab and primary percutaneous coronary intervention within 6 h.
  
  
  METHODS
  In 43 patients, (99m)Tc-sestamibi was injected before primary percutaneous coronary intervention. Gated SPECT was acquired immediately thereafter and was repeated 7 and 30 d later. The initial risk area and subsequent infarct size were expressed as a percentage of the left ventricle; salvage index was the ratio between salvaged myocardium and initial risk area; left ventricular ejection fraction was calculated using the quantitative gated SPECT software.
  
  
  RESULTS
  On admission, 20 patients showed elevated troponin I and had a larger risk area (P < 0.03) than did the group with normal troponin I. Infarct size at 30 d (15% +/- 12% vs. 13% +/- 13%) and salvage index (0.63 +/- 0.27 vs. 0.60 +/- 0.28) were not significantly different between the 2 groups. Ejection fraction was lower in the group with high troponin I on admission (36% +/- 10% vs. 41% +/- 11%, P < 0.05) and at 7 d (41% +/- 11% vs. 48 +/- 10, P < 0.03). At 30 d, improvement was greater in the group with high troponin I, and ejection fraction became comparable.
  
  
  CONCLUSIONS
  Patients with high troponin I on admission have a larger initial risk area, but if they undergo primary percutaneous coronary intervention within 6 h and are treated with abciximab, myocardial salvage and functional recovery are similar to those observed in patients with normal troponin I, and no unfavorable relationship between high troponin I values on admission and myocardial salvage is registered.
authors.affiliation: Division of Cardiology, Misericordia e Dolce Hospital, Prato, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Leoncini
authors.forename: Francesco
authors.initials: F
authors.lastname: Bellandi
authors.forename: Roberto
authors.initials: R
authors.lastname: Sciagrà
authors.forename: Mauro
authors.initials: M
authors.lastname: Maioli
authors.forename: Anna
authors.initials: A
authors.lastname: Toso
authors.forename: Angela
authors.initials: A
authors.lastname: Coppola
authors.forename: Stelvio
authors.initials: S
authors.lastname: Sestini
authors.forename: Alberto
authors.initials: A
authors.lastname: Mennuti
authors.forename: Roberto Piero
authors.initials: RP
authors.lastname: Dabizzi
authors.forename: Alberto
authors.initials: A
authors.lastname: Pupi
mesh_terms: D000077284:Abciximab; D015906:Angioplasty, Balloon, Coronary; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D004562:Electrocardiography; D005260:Female; D015637:Gated Blood-Pool Imaging; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000000981:diagnostic imaging* / Q000628:therapy*; D010343:Patient Admission; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D019275:Radiopharmaceuticals; D012306:Risk; D017256:Technetium Tc 99m Sestamibi; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D019210:Troponin I / Q000097:blood*
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D019275:Radiopharmaceuticals; D019210:Troponin I; D017256:Technetium Tc 99m Sestamibi; D000077284:Abciximab