Minimal residual coronary obstructions in patients who suffered a first myocardial infarction. A prospective study comparing coronary angiography and exercise thallium scintigraphy
| Autor: | Madalena Carvalho, I. Dionísio, António P. Lacerda, Mario Garcia-Alves, Eduardo Macieira-Coelho, Brás B. Da Costa, G Cantinho, Fernando de Pádua |
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| Rok vydání: | 1993 |
| Předmět: |
Adult
Male medicine.medical_specialty Ischemia Myocardial Infarction chemistry.chemical_element Coronary Disease Constriction Pathologic Scintigraphy Coronary Angiography Myocardial perfusion imaging Internal medicine medicine Humans cardiovascular diseases Myocardial infarction Prospective Studies Prospective cohort study Radionuclide Imaging Aged medicine.diagnostic_test business.industry Electrocardiography in myocardial infarction General Medicine Middle Aged medicine.disease Stenosis Thallium Radioisotopes chemistry cardiovascular system Cardiology Exercise Test Thallium Female Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Clinical cardiology. 16(12) |
| ISSN: | 0160-9289 |
| Popis: | The purpose of the present study was to correlate the presence of minimal coronary obstruction (< or = 50%) assessed by coronary angiography with the presence of myocardial scar and ischemia detected by thallium-201 myocardial perfusion imaging. The study included 83 consecutive patients (74 men and 9 women) with a mean age 55.4 +/- 8.5 years who suffered a first myocardial infarction and did not undergo thrombolytic therapy. In all patients, coronary angiography, left ventriculography, and exercise thallium-201 tomographic scintigraphy were performed within 3 to 5 months of the myocardial infarction. Coronary arteriograms showed minimal residual obstructions in 37 (45%) patients. Of a total of 54 patients with < or = 50% obstruction, 18 showed persistent defects and 22 reversible defects on thallium scintigrams. The present study showing estimated angiographic stenosis of < or = 50% as being responsible either for myocardial scar or myocardial ischemia on postexercise thallium scintigrams leads us to conclude that percent value of stenosis does not accurately predict the pathophysiologic significance of coronary atherosclerotic lesions in patients who suffer a myocardial infarction. After a first myocardial infarction, coronary angiographies and thallium-201 scintigrams are complementary for an optimal treatment strategy for selected subsets of patients. |
| Databáze: | OpenAIRE |
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