title: International variations in the ischemic burden post-acute myocardial infarction: prognostic implications.
abstract: OBJECTIVE
  To determine if there is a variation in the ischemic burden post-acute myocardial infarction (AMI), as assessed by myocardial perfusion imaging (MPI), between different populations in different geographic locations and to see if this variation is associated with different clinical outcomes.
  
  
  RESULTS
  We characterized the MPI findings in 104 stable patients who were hospitalized with AMI at the American University of Beirut Medical Center (AUBMC), a tertiary referral hospital in an East Mediterranean country and we compared them to 126 patients who were enrolled according to a similar protocol in a previous study done at Baylor College of Medicine (BCM), Houston, Texas. There were no differences between the two populations with respect to prevalence of diabetes, hypertension, smoking, the use of thrombolysis, percentage of anterior MIs, Q-wave MIs, and multivessel disease on coronary angiography. However, the quantified ischemic defect size in the BCM population was double that in the AUBMC population (12 +/- 12% vs 6 +/- 8%, P < .01). This was associated with almost doubling of the 1 year event rate of death/myocardial infarction (18.3% vs 10.6%, P = .02) in the BCM population.
  
  
  CONCLUSIONS
  Our study suggests that the ischemic burden post-AMI, as assessed by MPI, might vary between different populations in different geographic locations. This variation carries important prognostic implications and is associated with different patient outcomes.
authors.affiliation: Department of Internal Medicine, American University of Beirut, Beirut, P.O. Box 11-0236/A38, Lebanon. hd01@aub.edu.lb
authors.forename: Habib A
authors.initials: HA
authors.lastname: Dakik
authors.forename: Mouhammad
authors.initials: M
authors.lastname: Abdallah
authors.forename: Wassef
authors.initials: W
authors.lastname: Karrowni
authors.forename: Samir
authors.initials: S
authors.lastname: Alam
authors.forename: Samir
authors.initials: S
authors.lastname: Arnaout
authors.forename: Antoine
authors.initials: A
authors.lastname: Nasrallah
authors.forename: Loulou
authors.initials: L
authors.lastname: Kobeissi
authors.forename: John
authors.initials: J
authors.lastname: Mahmarian
mesh_terms: D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D038622:Internationality; D007861:Lebanon / Q000453:epidemiology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D017682:Myocardial Stunning / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D011379:Prognosis; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity