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European Heart Journal 1988 9(12):1324-1331;
Copyright © 1988 by the European Society of Cardiology.
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© 1988 The European Society of Cardiology

Dipyridamole–thallium 201 scintigraphy in the early post-infarction period: (Safety and accuracy in predicting the extent of coronary disease and future recurrence of angina in patients suffering from their first mycocardial infarction)

S. PIRELLI, E. INGLESE, M. SUPPA, E. CORRADA and L. CAMPOLO

Centro A. De Gasperis, Ente Ospedaliero Niguarda – Ca' Granda Piazza Ospedale Maggiore 3, 20162 Milano, Italy

Received 23 November 1987; revised 17 June 1988; .

Abstract

To evaluate the safety and usefulness of myocardial thallium-201 scintigraphy after intravenous dipyridamole during the early post-infarction period, 35 patients under 60 years of age and with recent first transmural uncomplicated myocardial infarction (27 inferior, 8 anterior) were examined between the 5th and 13th day of hospilization. Although four patients experienced angina and transient ischemic ST depression during the test, there were no serious complications. Patients were followed for a mean period of 11.4±6.3 months after hospital dicharge. None of the patients experienced recurrent infarction and there were no cardiac deaths. In 11 patients there were reversible prefusion defects in areas different from those of myocardial infarction. Of these patients, seven (one with infarct vessel stenosis only and six with multivessel coronary disease) developed angina during the follow-up: five underwent coronary surgery because of severe angina refractory to full medical theraphy. Out of the 24 patients without reversible perfusion defects, only two (with multivessel coronary disease) showed typical angina sysmptoms. The presence of redistribution on thallium scans was significantly more frequent in patients who developed a recurrence of angina over a period of 11.4±6.3 months of follow-up (p<0.0005). Thus dipyridamole–thallium 201 scintigraphy is a safe, non-invasive stress test which may be used early following uncomplicated myocardial infarction in order to indentify patients at risk for the recurrence of angina.

Key Words: Risk Stratification (after myocardial infarction), • thallium perfusion defects, • dipyridamole-thallium 201 scintigraphy.


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