Correlation of antecedent stress myocardial perfusion imaging with the infarct related artery in ST-elevation myocardial infarction

Yumiko Kanei, Yili Huang, John T. Fox, Maurice Rachko, Steven R. Bergmann

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: While stress myocardial perfusion imaging (MPI) has strong prognostic power, it predicts the site of a subsequent acute myocardial infarction (AMI) in only 47-77% of patients. Prior studies have included small number of subjects and the interval between the stress test and the AMI has varied. The objective of the present study was to further evaluate the relationship between antecedent stress MPI and subsequent AMI. Methods: We screened 600 patients admitted to our institution with acute ST-elevation MI and identified 21 patients who had a stress MPI an average of 4.8 months prior to the event. The location of perfusion defects on MPI were compared to the angiographic findings at the time of the subsequent AMI. Results: Sixteen patients (76%) with AMI had defects on antecedent stress MPI while 5 patients (24%) had normal scans. Reversible or fixed perfusion defects in the territory corresponding to the site of AMI were seen in 62% of patients. All 5 patients with normal scans had multiple risk factors for coronary artery disease. Conclusion: Although a normal stress MPI portends an excellent outcome, a small proportion of patients with normal scans, but with risk factors go on to develop AMI. Stress MPI has reasonable power in predicting future STEMI, but a lesser degree for the location of the future MI. Complementary imaging approaches such as coronary calcium scoring or CT angiography may be beneficial in the assessment of patients at high risk for MI.

Original languageEnglish
Pages (from-to)145-149
Number of pages5
JournalInternational Journal of Cardiovascular Imaging
Volume25
Issue number2
DOIs
StatePublished - 2009
Externally publishedYes

Keywords

  • Plaque rupture
  • ST-Segment elevation myocardial infarction
  • Stress myocardial perfusion imaging

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