Evaluation of prognostic effect of medical management in coronary artery disease patients using Thalium 201 single photon emission computed tomographic imaging

Abstract

Besides its use for detecting coronary artery disease (CAD), myocardial perfusion imaging (MPI) is increasingly used to provide prognostic evaluation of patients with suspected or proven CAD. The combination of several scintigraphic variables allows separation of patients at low and high risk for future events. Exercise induced perfusion abnormalities are associated with increased cardiovascular risk. Recent studies have shown that the extent of the perfusion abnormality and the number of defects represent an independent predictor of cardiovascular complications. Large exercise induced perfusion abnormalities carry a risk of cardiovascular death that is 14 times higher than in patients with normal

scans.

Patients with large reversible perfusion defects on myocardial perfusion .

imaging (MPI) are at high risk and need coronary angiography and revascularization.

The goal of this study is to evaluate the effeci of medical management on the short term prognosis of patients with large reversible perfusion defects using myocardial perfusion imaging.

This study was conducted in Assiut University Hospital and AI Hussein University Hospital. The practical part of the study took place in AI Hussein University Hospital. Thirty two patients referred to the cardiac nuclear lab at AI Hussein University Hospital, AI Azhar University for evaluation of coronary artery disease were enrolled in this study in the period between August 1999 and July 2001. All patients had large reversible perfusion defects on MPI and refused to undergo revascularization.