To evaluate the safety and usefulness of serial thallium scanning immediately after intravenous dipyridamole, we studied 51 patients recovering from acute myocardial infarction. Eight patients experienced angina during the procedure, but there were no serious complications. Patients were followed for a mean period of 19 months after hospital discharge. Eleven of 12 patients who died during follow-up or had another infarction had shown transient defects (redistribution) on their predischarge scan, as had 22 of the 24 patients who needed readmission for management of angina. Among all the other clinical or scintigraphic criteria tested, the presence of redistribution on the dipyridamole-thallium scan was the only significant predictor of these serious cardiac events. Twenty-six patients were also given a submaximal exercise test before discharge, of whom 13 subsequently had serious cardiac events. The exercise test had been positive in only 6 of these 13 patients, whereas the dipyridamole-thallium scan had shown a redistribution pattern in 12 (P less than 0.001). We conclude from this preliminary study that dipyridamole-thallium scintigraphy after myocardial infraction is relatively safe. It appears to be a more sensitive predictor of subsequent cardiac events than a submaximal exercise test and may therefore prove useful in evaluating patients after recovery from a myocardial infarction.
This article has been cited by other articles:
Kim, H.-H., Liao, J. K.
(2008). Translational Therapeutics of Dipyridamole. Arterioscler. Thromb. Vasc. Bio.
28: s39-s42
[Abstract][Full Text]
Udelson, J E, Flint, E J
(2004). Radionuclide imaging in risk assessment after acute coronary syndromes. Heart
90: v16-v25
[Full Text]
Miyagawa, M., Mochizuki, T., Murase, K., Tanada, S., Ikezoe, J., Sekiya, M., Hamamoto, K., Matsumoto, S., Niino, M.
(1998). Prognostic Value of Dipyridamole-Thallium Myocardial Scintigraphy in Patients With Kawasaki Disease. Circulation
98: 990-996
[Abstract][Full Text]
Basu, S., Senior, R., Raval, U., Lahiri, A.
(1997). Superiority of Nitrate-Enhanced 201Tl Over Conventional Redistribution 201Tl Imaging for Prognostic Evaluation After Myocardial Infarction and Thrombolysis. Circulation
96: 2932-2937
[Abstract][Full Text]
Hung, J., Moshiri, M., Groom, G. N, Van der Schaaf, A. A, Parsons, R. W, Hands, M. E
(1997). Dipyridamole thallium-201 scintigraphy for early risk stratification of patients after uncomplicated myocardial infarction. Heart
78: 346-352
[Abstract][Full Text]
Dakik, H. A., Mahmarian, J. J., Kimball, K. T., Koutelou, M. G., Medrano, R., Verani, M. S.
(1996). Prognostic Value of Exercise 201Tl Tomography in Patients Treated With Thrombolytic Therapy During Acute Myocardial Infarction. Circulation
94: 2735-2742
[Abstract][Full Text]
Basu, S., Senior, R., Dore, C., Lahiri, A.
(1996). Value of thallium-201 imaging in detecting adverse cardiac events after myocardial infarction and thrombolysis: a follow up of 100 consecutive patients. BMJ
313: 844-848
[Abstract][Full Text]
Niemeyer, M.G., van der Wall, E.E., Kuijper, A.F.M., Cleophas, A.T., Pauwels, E.K.J.
(1995). Nuclear Cardiology, Current Applications in Clinical Practice. ANGIOLOGY
46: 591-602
[Abstract]
Cicatiello, A.M., Landino, P., Simonelli, P., Del Mastro, L., Ferrara, P., Cioppa, A., Ciaburri, F.
(1995). Safety of Echo-Dipyridamole Test in Elderly Patients with Coronary Artery Disease. ANGIOLOGY
46: 321-326
[Abstract]
Hendel, R. C., Chen, M. H., L'Italien, G. J., Newell, J. B., Paul, S. D., Eagle, K. A., Leppo, J. A.
(1995). Sex Differences in Perioperative and Long-term Cardiac Event–Free Survival in Vascular Surgery Patients : An Analysis of Clinical and Scintigraphic Variables. Circulation
91: 1044-1051
[Abstract][Full Text]
Niemeye, M.G., Van der Wall, E.E., Pauwels, E.K.J., van Dijkman, P.R.M., Blokland, J.A.K., de Roos, A., Bruschke, A.V.G.
(1992). Assessment of Acute Myocardial Infarction by Nuclear Imaging Techniques. ANGIOLOGY
43: 720-733
[Abstract]
Jain, A., Hunter Myers, G., Rowe, M. W., Dehmer, G. J., Robinson, D. S.
(1991). Comparison of Coronary Angiographic Features and Oral Dipyridamole Thallium 201 Tomography. ANGIOLOGY
42: 99-105
[Abstract]
Previous
