Value of radionuclide angiography for predicting specific cardiac events after acute myocardial infarction

• Published in: The American journal of cardiology Vol. 55; no. 4; pp. 318 - 324
• Main Authors: Morris, Kenneth G., Palmeri, Sebastian T., Califf, Robert M., McKinnis, Ray A., Higginbotham, Michael B., Coleman, R.Edward, Cobb, Frederick R.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-02-1985; Elsevier
• Subjects: Adult; Aged; Angina, Unstable - physiopathology; Angina, Unstable - surgery; Biological and medical sciences; Cardiology. Vascular system; Coronary Artery Bypass; Coronary heart disease; Exercise Test; Female; Follow-Up Studies; Heart; Humans; Male; Medical sciences; Middle Aged; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - mortality; Myocardial Infarction - physiopathology; Prognosis; Prospective Studies; Radionuclide Imaging; Recurrence; Rest; Stroke Volume; Radionuclide study; Human; Prognosis; Infarct; Acute; Myocardium; Cardiovascular disease; Radioisotope; Coronary heart disease; Angiocardiography
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(85)90368-6

The value of rest and exercise radionuclide angiography (RNA) for predicting specific events including death, recurrent acute myocardial infarction (AMI), coronary care unit readmission for unstable chest pain, and medically refractory angina after AMI was studied in 106 consecutive survivors of AMI. Analysis of the RNA variables using the Cox proportional hazards regression model yielded significant associations of the time to death with ejection fraction at rest and during exercise (
χ
2 = 11.1 and 14.0, respectively). Both variables added significant prognostic information to the clinical assessment (
χ
2 = 4.3 and 5.7, respectively). The change in ejection fraction from rest to exercise predicted the time to coronary artery bypass grafting for medically refractory angina before (
χ
2 = 21.0) and after (
χ
2 = 13.2) adjustment for the clinical descriptors, but did not predict death or other nonfatal events. Significant correlations were found between RNA variables and a variety of clinical descriptors previously reported to have prognostic significance. Clinical and RNA variables that are measures of left ventricular function were predictive of subsequent mortality, whereas those that reflect residual potentially ischemic myocardium were predictive of subsequent nonfatal ischemic events. Rest and exercise RNA after AMI provides significant prognostic information regarding specific events during follow-up independent of that provided by clinical assessment.