Prognostic value of stress Tc-99m tetrofosmin SPECT in patients with previous myocardial infarction: Impact of scintigraphic extent of coronary artery disease

Background: Myocardial bridging (MB) is frequently seen on coronary CT angiography (CCTA). However, there has been conflicting data on the prognostic value of MB. The aim of this analysis is to determine the prognostic value of MB in patients without obstructive coronary artery disease (CAD) (<50 diameter stenosis). Methods: We included patients with no known prior coronary artery disease (CAD) who underwent CCTA for various clincial reasons. Patients with obstructive CAD on CCTA were excluded. The study cohort was followed for all cause mortality or myocardial infarction (MI) (median follow-up 1.7 years). Group comparisons were made between patients with patients with or without MB. Results: A total of 715 patients were included in this analysis of which 68 patients had MB (10%). 73% of the bridges were in the mid LAD and 22% had bridging in the distal LAD. 48% of the study cohort had normal coronaries, while 52% had evidence of non obstructive CAD. There were no differences in the baseline characteristics, symptomatic status or prevalence of non obstructive CAD between the two groups (all p>0.5). After a median follow-up duration of 1.7 years, 23 patients died and 10 patients experienced myocardial infarction. There were no statistically significant differences in the rate of death/MI between the two groups (figure). Using multivariable Cox regression, the presence of MB was not associated with increased risk for death/MI (Adjusted HR 0.4, 95% confidence interval 0.1 -2.8, p=0.34) Conclusions: In patients with non-obstructive CAD, MB is not associated with increased risk for all cause death or MI.

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Platelet aggregation and fibrin clot structure in patients with coronary artery disease and previous myocardial infarction

European Heart Journal ◽

10.1093/eurheartj/eht310.p4904 ◽

2013 ◽

Vol 34 (suppl 1) ◽

pp. P4904-P4904

Author(s):

S. Neergaard-Petersen ◽

R. Ajjan ◽

A. M. Hvas ◽

K. Hess ◽

S. B. Larsen ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Platelet Aggregation ◽

Fibrin Clot ◽

Previous Myocardial Infarction ◽

Artery Disease ◽

Clot Structure

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4.61 Additive prognostic informations by gated-SPECT in patients with coronary artery disease and previous myocardial infarction

Journal of Nuclear Cardiology ◽

10.1016/s1071-3581(01)80561-4 ◽

2001 ◽

Vol 8 (1) ◽

pp. S35-S35

Author(s):

M MAZZANTI ◽

G CIANCI ◽

D GABRIELLI ◽

G CARINI ◽

C SILENZI

Keyword(s):

Myocardial Infarction ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Gated Spect ◽

Previous Myocardial Infarction ◽

Artery Disease

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Plasma β-Thromboglobulin, Platelet Factor 4 And Fibrinopeptide A In Patients With Coronary Artery Disease

10.1055/s-0038-1652797 ◽

1981 ◽

Cited By ~ 1

Author(s):

A Nichols ◽

J Owen ◽

K L Kaplan ◽

P J Cannon ◽

H L Nossel ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Left Ventricular ◽

Fibrinopeptide A ◽

Ventricular Aneurysm ◽

Previous Myocardial Infarction ◽

Platelet Factor ◽

Group Iii ◽

Artery Disease

To determine whether activation of platelets and coagulation is present in patients with coronary artery disease, plasma levels of platelet factor 4 (PF4), β-thromboglobulin (βTG), and fibrinopeptide A (FPA) were measured by radioimmunoassay in patients subjected to coronary angiography. The patients were divided into those with normal coronary angiograms (Group I, n = 14), those with coronary artery disease (> 70% narrowing) but no previous myocardial infarction (Group II, n = 32), and those with coronary artery disease and documented previous myocardial infarction (Group III, n = 36). The three groups did not differ in sex, incidence of hypertension or diabetes, serum cholesterol, HDL cholesterol, BUN or platelet count. Geometric mean values for the three groups were FPA: 0.77, 0.81 and 1.01 pmol/ml respectively, βTG: 22.7, 21.6 and 33.2 ng/ml respectively, and PF4: 5.7, 5.8 and 8.3 ng/ml respectively. When the data were tested by analysis of variance, significant elevations of βTG (p< .01) and PF4 (p< .05) were found in Group III but there were no other significant changes. When Group III was subdivided into patients with and without ventricular aneurysm, BTG and FPA levels were found to be higher in patients with aneurysm than without: βTG 45.9 vs. 30.3 ng/ml and FPA 1.64 vs. 0.88 pmol/ml (p< .05 for each). βTG levels were also higher in patients with congestive heart failure (p< .01) and showed an inverse correlation with left ventricular ejection fraction (p< .05) and a direct correlation with the extent of left ventricular asynergy (p< .01). In conclusion, elevations in βTG and PF4 were associated with previous infarction, not with coronary artery disease. These changes are thought to reflect platelet reaction with the damaged ventricular wall. Elevations in FPA were seen only in patients with ventricular aneurysm and may reflect mural thrombus within the aneurysm.

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