Myocardial scintigraphy with 99mTc-pyrophosphate predicted complications, with rates rising from 10% in patients with normal scintigrams to 88% in those with massive uptake.
Cohort (n=100)
Absolute Event Rate: 88% vs 10%
The predictive value of the myocardial scintigraphy with 99mTc-pyrophosphate was studied in 100 patients admitted to the coronary care unit with suspected acute myocardial infarction. None of the 21 patients with normal scintigrams had acute myocardial infraction by other criteria. Fifty-five percent of patients with diffuse uptake (pattern B), 73% of patients with focal uptake (pattern C) and all patients with intense focal uptake (pattern D) and massive uptake (pattern E) had acute infarction. The complication rate in the hospital and after discharge (mean followup: 6.1 months) for patients with pattern E was 88% compared to 42% for D, 30% for C, 36% for B and 10% for patients with normal scintigrams (A). For patients with acute infarction with patterns C, D and E, the complication rate rose with increasing size of the myocardial uptake of 99mTc-pyrophosphate. In addition to its diagnostic potential, scintigraphy provides prognostic information which is useful for patient triage and for therapeutic decisions early in the evolution of the infarct.
Holman et al. (Wed,) conducted a cohort in Suspected acute myocardial infarction (n=100). Myocardial scintigraphy with 99mTc-pyrophosphate (massive uptake / pattern E) vs. Normal scintigrams (pattern A) was evaluated on Complication rate in the hospital and after discharge. Myocardial scintigraphy with 99mTc-pyrophosphate predicted complications, with rates rising from 10% in patients with normal scintigrams to 88% in those with massive uptake.