Multidetector row computed tomography noninvasively assesses coronary reperfusion after thrombolytic therapy in patients with ST elevation myocardial infarction.
BACKGROUND
The study objective was to assess the efficacy of 16-slice multidetector row computed tomography (MDCT) in estimating residual stenosis and successful reperfusion after thrombolysis in patients with ST-elevation myocardial infarction (STEMI).


RESULTS
A total of 31 patients with STEMI underwent MDCT scanning within 6 h (mean 4.6+/-1.1) after thrombolysis and the results for detection of significant residual stenosis and distal flow of the infarct-related artery were compared with those from conventional coronary angiography (CCAG) performed within 24 h (mean 12.1+/-5.6) after the MDCT scan. Successful reperfusion was defined as Thrombolysis In Myocardial Infarction flow 2 or 3 on CCAG and full contrast enhancement of the distal artery landmarks on MDCT. A final analysis was performed using 24 patients (312 segments). MDCT had a positive predictive value of 73.3% and a negative predictive value of 95.1% for detecting significant residual stenosis. It accurately estimated 17 of 18 patients (94.4%) with successful reperfusion and 5 of 6 (83.3%) with failed reperfusion on the basis of comparison with CCAG.


CONCLUSIONS
MDCT demonstrated high accuracy not only for the detecting residual stenosis, but also for assessing successful reperfusion after thrombolytic therapy in patients with STEMI.
Shin
Dong Il
DI
Department of Internal Medicine, The catholic University of Korea, Seoul, South Korea.
Won
Yoo Dong
YD
Chang
Kiyuk
K
Seung
Woo
W
Kim
Pum Joon
PJ
Park
Yun Jung
YJ
Jung
Hae Ok
HO
Jeon
Hee Kyung
HK
Baek
Sang Hong
SH
Chung
Wook Sung
WS
Kim
Ki Tae
KT
Kim
Youn-Jeong
YJ
Seung
Ki-Bae
KB
D017023:Coronary Angiography; D003326:Coronary Circulation; D023921:Coronary Stenosis / Q000000981:diagnostic imaging; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed / Q000379:methods*