Correlation of antecedent stress myocardial perfusion imaging with the infarct related artery in ST-elevation myocardial infarction.
BACKGROUND
While stress myocardial perfusion imaging (MPI) has strong prognostic power, it predicts the site of a subsequent acute myocardial infarction (AMI) in only 47-77% of patients. Prior studies have included small number of subjects and the interval between the stress test and the AMI has varied. The objective of the present study was to further evaluate the relationship between antecedent stress MPI and subsequent AMI.


METHODS
We screened 600 patients admitted to our institution with acute ST-elevation MI and identified 21 patients who had a stress MPI an average of 4.8 months prior to the event. The location of perfusion defects on MPI were compared to the angiographic findings at the time of the subsequent AMI.


RESULTS
Sixteen patients (76%) with AMI had defects on antecedent stress MPI while 5 patients (24%) had normal scans. Reversible or fixed perfusion defects in the territory corresponding to the site of AMI were seen in 62% of patients. All 5 patients with normal scans had multiple risk factors for coronary artery disease.


CONCLUSIONS
Although a normal stress MPI portends an excellent outcome, a small proportion of patients with normal scans, but with risk factors go on to develop AMI. Stress MPI has reasonable power in predicting future STEMI, but a lesser degree for the location of the future MI. Complementary imaging approaches such as coronary calcium scoring or CT angiography may be beneficial in the assessment of patients at high risk for MI.
Kanei
Yumiko
Y
Division of Cardiology, Department of Internal Medicine, Beth Israel Medical Center, 1st Avenue at 16th Street, New York, NY 10003, USA. yumikanei@hotmail.com
Huang
Yili
Y
Fox
John T
JT
Rachko
Maurice
M
Bergmann
Steven R
SR
D006328:Cardiac Catheterization; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D019275:Radiopharmaceuticals; D012307:Risk Factors
D019275:Radiopharmaceuticals
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