Long-term risk stratification with dipyridamole imaging
| Autor: | Stanley Nattel, Carole Bertrand, Michel Picard, Marie-Claire Eybalin, Andre Levasseur, Michel Cerino, Jean Lette, Daniel McNamara, Denis Gossard, Onorio Ruscito |
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| Rok vydání: | 1995 |
| Předmět: |
Male
medicine.medical_specialty Myocardial Infarction Coronary Disease Scintigraphy Left ventricular hypertrophy Risk Assessment Myocardial perfusion imaging Electrocardiography Internal medicine medicine Humans Myocardial infarction Radionuclide Imaging Aged Proportional Hazards Models Likelihood Functions medicine.diagnostic_test business.industry Mortality rate Heart Dipyridamole Middle Aged medicine.disease Transient Ischemic Dilation Prognosis Survival Analysis Thallium Radioisotopes cardiovascular system Cardiology Exercise Test Female Cardiology and Cardiovascular Medicine business Perfusion medicine.drug Follow-Up Studies |
| Zdroj: | American heart journal. 129(5) |
| ISSN: | 0002-8703 |
| Popis: | This study was undertaken to assess the reliability of clinical parameters and dipyridamole—thallium 201 images for predicting the occurrence of future cardiac events (nonfatal myocardial infarction or cardiac death). Dipyridamole myocardial perfusion imaging is routinely performed in patients who have possible or known coronary disease and a low exercise tolerance. A total of 753 patients underwent clinical assessment and semiquantitative dipyridamole—201TI imaging and were followed up as outpatients. Patients who underwent coronary revascularization during the follow-up period were excluded from the study because the decision to intervene would have been based at least in part on the test itself. There were 82 cardiac events and 54 noncardiac deaths, and 11 patients were lost to follow-up after a mean follow-up of 15 months. With use of a quantitative index reflecting the amount of jeopardized myocardium, patients could be stratified by dipyridamole imaging into subsets with coronary morbidity and mortality rates ranging from 1% to 89%, (p = 0.0001). When clinical and scintigraphic variables were subjected to backward stepwise logistic regression analysis, the significant predictors of cardiac events were the jeopardized myocardium index by scintigraphy (p < 0.0001), left ventricular hypertrophy on the electrocardiogram (p = 0.0009), and transient dipyridamole—induced left ventricular cavitary dilatation (p = 0.0073). Quantitative dipyridamole—201TI imaging appears to be a powerful predictor of future cardiac events in patients with coronary disease and a low exercise tolerance and is a potentially useful contributor to risk-profile assessment and to the treatment of these patients. |
| Databáze: | OpenAIRE |
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