technetium-tc-99m-pyrophosphate and Death--Sudden--Cardiac

This study was undertaken to determine whether the findings of dual SPECT with Tc-99m pyrophosphate (PYP) and Tl-201 were predictive of further cardiac events after acute myocardial infarction.. The authors evaluated 88 patients with acute myocardial infarction who underwent dual SPECT for single-vessel coronary artery disease.. Twenty-nine patients showed overlapping of Tc-99m PYP and Tl-201 in the same location (overlap-positive group), and 59 patients had no overlap (overlap-negative group). In patients in the overlap-positive group, the incidence of subsequent events was significantly higher than in patients in the overlap-negative group (P < 0.001). In the overlap-positive group, the number of overlap segments in patients with further events was significantly greater than that in patients without further events (P < 0.005).. Areas with overlapping of Tc-99m PYP and Tl-201 may contain jeopardized myocardium. These results suggest that patients who have a Tc-99m PYP and Tl-201 overlap-negative scan are a low risk group, whereas patients who have more overlapping segments may require catheterization and revascularization. Thus simultaneous SPECT imaging with Tc-99m PYP and Tl-201 might be useful to identify patients with greater ischemic risk after acute myocardial infarction.

Topics: Aged; Angina Pectoris; Angioplasty, Balloon, Coronary; Cardiac Catheterization; Coronary Artery Bypass; Coronary Disease; Death, Sudden, Cardiac; Female; Follow-Up Studies; Forecasting; Heart; Humans; Image Processing, Computer-Assisted; Incidence; Male; Middle Aged; Myocardial Infarction; Myocardial Ischemia; Predictive Value of Tests; Radiopharmaceuticals; Recurrence; Risk Factors; Technetium Tc 99m Pyrophosphate; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon