Incremental predictive value of myocardial scintigraphy with ~(123)I-BMIPP in patients with acute myocardial infarction treated with primary percutaneous coronary intervention

摘要

Purpose, It is unclear whether ~(123)I-labelled P-methyl iodophenyl pentadecanoic acid (~(123)I-BMIPP) myocardial scintigiaphy adds further predictive value for future cardiac events compared with the variables obtained during cardiac catheterisation in patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI). We therefore investigated whether ~(123)I-BMIPP imaging in patients with AMI treated by primary PCI was useful in predicting future cardiac eventsMethods, One hundred and fifty-nine patients with AMI who were treated with primary PCI and underwent left ventriculography (LVG) on admission underwent ~(201)Tl and ~(123)I-BMIPP myocardial scintigraphy, Scintigrams were visually classified, and the total defect score (TDS) was calculated. Major adverse cardiac events (MACE) were defined as cardiac death including sudden death, congestive heart failure and recurrence of acute coronary syndrome. Patients were followed up for a mean of 34 5 months (12-63 months).Results. Twenty-six patients had MACE. Kaplan-Meier analysis indicated that patients with the top 50% of ~(123)I-BMIPP TDSs had a significantly higher rate of MACE (P=0 007), Patients with mismatch between ~(201)Tl and ~(123)I-BMIPP images also had significantly more MACE (P=0.02). In the prediction of MACE, the global chi-square value was 5.2 (P=0.001) based on LVEF (<45%) and the number of diseased vessels (two or three) Adding ~(123)I-BMIPP TDS and the mismatch improved the global chi-square value (X~2=7.2)Conclusion,, Myocardial scintigraphy using ~(201)T1 and ~(123)I-BMIPP predicts future cardiac events in patients with AMI treated with primary PCI, and provides additional predictive value compared with the variables obtained with cardiac catheterisation alone.