Author + information
- Received November 30, 1992
- Revision received May 10, 1993
- Accepted June 7, 1993
- Published online November 15, 1993.
- Nagara Tamaki, MD∗,
- Masahide Kawamoto, MD,
- Norio Takahashi, MD,
- Yoshiharu Yonekura, MD,
- Yasuhiro Magata, PhD,
- Ryuji Nohara, MD,
- Hirofumi Kambara, MD,
- Shigetake Sasayama, MD, FACC,
- Kazuo Hirata, MD,
- Toshihiko Ban, MD and
- Junji Konishi, MD
- ↵∗Address for correspondence: Dr. Nagara Tamaki, Department of Nuclear Medicine, Kyoto University Faculty of Medicine, Shogoin, Sakyo-ku, Kyoto 606, Japan.
Objectives. This study was undertaken to evaluate the prognostic value of an increase in fluorine (F)-18 deoxyglucose uptake compared wilh clinical, angiographic and stress thallium findings in patients with myocardial infarction.
Background. Positron emission tomography (PET) imaging using F-18 deoxyglucose has been applied to assess tissue viability in patients with coronary artery disease. We hypothesized that patients with a myocardial segment with augmented F-18 deoxyglucose uptake are at high risk for a future cardiac event.
Methods. One hundred fifty-eight consecutive patients with myocardial infarction referred for F-18 deoxyglucose PET and stress thallium scans were studied. Follow-up was obtained in 84 patients at a mean interval of 23 months to investigate prognostic implications of radionuclide studies.
Results. Seventeen patients had a cardiac event during the follow-up interval. Univariate analysis showed that an increase in F-18 deosyglucose uptake was the best predictor of a future cardiac event (p = 0.0006), followed by the number of stenosed vessels (p = 0.008). In the multivariate analysis, when an increase in F-18 deoxyglucose uptake was entered into the model, only angiographic variables had an independent value, whereas no other radionuclide variables showed value. Among patients who did not show redistribution, a future cardiac event was observed more often in patients with than in those without an increase in F-18 deoxyglucose uptake (p < 0.05).
Conclusions. Thus, an increase in F-18 deoxyglucose uptake seemed to be the best predictor of a future cardiac event among all clinical, angiographic and redionuclide variables in this study of stable patients with myocardial infarction. Even when a stress thallium-201 scan does not show redistribution, those patients who have an increase in F-18 deoxyglucose uptake in a PET study may be at risk for a future cardiac event, and these patients may need aggressive treatment to prevent a future cardiac event.
☆ This work was supported in part by a grant-in-aid for General Scientific Research from the Ministry of Education, Science and Culture, Tokyo, Japan.
- Received November 30, 1992.
- Revision received May 10, 1993.
- Accepted June 7, 1993.