PROGNOSTIC-SIGNIFICANCE OF RESTING ANTERIOR TL-201 DEFECTS IN PATIENTS WITH INFERIOR MYOCARDIAL-INFARCTION

  • 1 January 1980
    • journal article
    • research article
    • Vol. 21  (11) , 1015-1021
Abstract
To determine whether Tl-201 scintigraphy performed at rest during the late hospital phase of inferior myocardial infarction can predict subsequent coronary events, 25 patients with historical, enzymatic and ECG criteria of transmural inferior infarction underwent serial imaging with computer quantification 7-35 days after admission. All 25 patients had inferior defects, and 13 (52%) also had anterior defects implying stenosis of the left anterior descending coronary artery. The patients were divided into those with inferior and anterior perfusion defects (Group 1) and those with inferior defects alone (Group 2). In Group 1, 3 patients had persistent defects in the anterior wall and 10 had initial defects with redistribution. New or recurrent coronary events, which included new onset or progression of angina pectoris, sudden death, reinfarction and congestive heart failure, were recorded over an average 7.2 mo. of follow-up (range 3-9 mo.) for all patients. Ten of 13 (77%) patients in Group 1 had 17 coronary events and four of 12 (33%) patients in Group 2 had 6 coronary events (P < 0.02). Nine patients in Group 1 and 3 in Group 2 developed angina (P < 0.03). The apparently increased prevalence of Group 1 of sudden death (8% against 0%), reinfarction (8% against 0%) and congestive heart failure (46% against 25%) was not statistically significant. Resting Tl-201 scintigraphy with computer quantification is a highly sensitive method to detect inferior myocardial infarction even in the late hospital phase. It appears to identify those patients with inferior infarction at high risk for subsequent coronary events, presumably due to stenosis of the left anterior descending coronary artery.