Sestamibi single photon emission computed tomography immediately after primary percutaneous coronary intervention identifies patients at risk for large infarcts

American Heart Journal
Anne K KaltoftTorsten T Nielsen

Abstract

Primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction results in TIMI 3 flow in most patients. However, despite TIMI 3 flow, some patients do not achieve adequate tissue perfusion and have large infarctions. Techniques that, in the acute setting, could identify these patients at increased risk would potentially enable specific interventions to enhance perfusion. The object of the present study was to test whether corrected TIMI frame count (CTFC), myocardial blush grade (MBG), ST-segment resolution, and myocardial perfusion imaging (MPI) can identify those patients who, despite successful treatment with primary PCI for ST-elevation myocardial infarction, are at risk for large infarcts. In 61 patients with TIMI 3 flow after primary PCI, CTFC, MBG, ST-segment resolution, and quantitative MPI by technetium Tc 99m sestamibi single photon emission computed tomography were estimated immediately after primary PCI. Infarct size was assessed by peak lactate dehydrogenase (LDH) and by MPI after 3 months. Infarct size by MPI was 12% (4, 23), and peak LDH was 1410 U/L (870, 2220); these measures correlated (rho = 0.80, P < .001). The acute perfusion defect predicted infarct size using either method (MPI rh...Continue Reading

References

Apr 4, 1985·The New England Journal of Medicine·UNKNOWN TIMI Study Group
Jan 1, 1993·European Journal of Nuclear Medicine·P CraneC Orlandi
Jun 23, 2001·The New England Journal of Medicine·G MontalescotUNKNOWN ADMIRAL Investigators. Abciximab before Direct Angioplasty and Stenting in Myocardial Infarction Regarding Acute and Long-Te

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Citations

Jun 13, 2009·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Anne KaltoftLeif Thuesen
May 3, 2008·IEEE Transactions on Medical Imaging·D GilJ Mauri
Dec 15, 2010·American Heart Journal·Italo PortoFilippo Crea
Sep 4, 2007·Journal of the American College of Cardiology·Raymond J GibbonsEric E Williamson
Nov 2, 2012·Journal of Cardiovascular Medicine·Michael R SchmidtHans E Bøtker

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