PROGNOSTIC VALUE OF TL-201 EXERCISE SCINTIGRAPHY IN LOW-RISK PATIENTSAFTER Q-WAVE MYOCARDIAL-INFARCTION - COMPARISON WITH EXERCISE TESTINGAND CATHETERIZATION

In a prospective study of 100 consecutive patients discharged after a Q-wave myocardial infarction, the value of reversible ischemia on thal lium-201 scintigraphy to assess the risk of cardiac events (death or r einfarction) during 4 years was compared with variables from exercise testing and cardiac catheterization. Patients with markedly impaired l eft ventricular function [ejection fraction (EF) less-than-or-equal-to 0.301 were excluded. During follow-up there were 20 cardiac events (1 0 cardiac deaths and 10 reinfarctions). Thallium-201 scintigraphy was significantly better than all exercise test variables and better than an EF <0.40, with good sensitivity and specificity (75 and 51%, respec tively). Exercise-induced reversible ischemia on scintigraphy yielded the same information as the presence of multivessel disease. Exercise test variables were of limited value to assess prognosis. Thus, thalli um-201 scintigraphy can be used as the only tool to predict future car diac events in low-risk patients after a Q-wave myocardial infarction.