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Long-term prognostic value of 201Tl single-photon emission computed tomographic myocardial perfusion imaging after coronary stenting



Long-term prognostic value of 201Tl single-photon emission computed tomographic myocardial perfusion imaging after coronary stenting



American Heart Journal 141(6): 999-1006



The prognostic value of (201)Tl myocardial imaging has been demonstrated in several studies concerning patients with a known significant coronary artery disease. However, the evolution of a coronary stenosis after stenting is difficult to predict. This study was designed to assess the prognostic value of (201)Tl single-photon emission computed tomography (thallium SPECT) perfusion imaging in patients after intracoronary stenting. One hundred fifty-two patients were studied. They were followed up during 40 +/- 13 (mean +/- SD) months after thallium SPECT. Stent-related events were studied after thallium stress testing and included cardiovascular death, myocardial infarction, and revascularization. Stress thallium imaging was performed 5 +/- 2 months after stenting, and ischemia was considered to be present if at least 2 contiguous segments were showing reversible defects. Only 3 (3%) among the 105 nonischemic patients had major cardiac events during the follow-up versus 13 (28%) of the 47 ischemic patients (P < .001) after thallium SPECT. The relative risk of major cardiac events for patients with significant ischemia was 10.5 compared with nonischemic patients (P < .001). Fourteen (30%) of the ischemic patients and 8 (8%) among the nonischemic patients underwent iterative revascularization (P < .001). Therefore, only 11 (10%) of the nonischemic patients had major cardiac events or revascularization compared with 24 (51%) of the ischemic patients (P < .001). Absence of ischemia on thallium SPECT imaging at 5 months after coronary stenting indicates a low risk for cardiovascular events or interventional procedure. These results may have important clinical implications in patient treatment.

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Accession: 010936630

Download citation: RISBibTeXText

PMID: 11376316

DOI: 10.1067/mhj.2001.114970


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