Multidetector Row Computed Tomography Noninvasively Assesses Coronary Reperfusion After Thrombolytic Therapy in Patients With ST Elevation Myocardial Infarction

Background The study objective was to assess the efficacy of 16-slice multidetector row computed tomography (MDCT) in estimating residual stenosis and successful reperfusion after thrombolysis in patients with ST-elevation myocardial infarction (STEMI). Methods and Results A total of 31 patients wit...

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Published in:Circulation Journal 2006, Vol.70(12), pp.1590-1597
Main Authors: Shin, Dong Il, Won, Yoo Dong, Chang, Kiyuk, Seung, Woo, Kim, Pum Joon, Park, Yun Jung, Jung, Hae Ok, Jeon, Hee Kyung, Baek, Sang Hong, Chung, Wook Sung, Kim, Ki Tae, Kim, Youn-Jeong, Seung, Ki-Bae
Format: Article
Language:English
Subjects:
Coronary Angiography
Coronary Circulation
Coronary reperfusion
Coronary Stenosis - diagnostic imaging
Female
Heart - diagnostic imaging
Humans
Male
Middle Aged
Multidetector row computed tomography (MDCT)
Myocardial Infarction - diagnostic imaging
Myocardial Infarction - drug therapy
Myocardial Infarction - physiopathology
ST elevation myocardial infarction (STEMI)
Thrombolytic Therapy
Tomography, X-Ray Computed - methods
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Summary:Background The study objective was to assess the efficacy of 16-slice multidetector row computed tomography (MDCT) in estimating residual stenosis and successful reperfusion after thrombolysis in patients with ST-elevation myocardial infarction (STEMI). Methods and Results A total of 31 patients with STEMI underwent MDCT scanning within 6 h (mean 4.6±1.1) after thrombolysis and the results for detection of significant residual stenosis and distal flow of the infarct-related artery were compared with those from conventional coronary angiography (CCAG) performed within 24 h (mean 12.1±5.6) after the MDCT scan. Successful reperfusion was defined as Thrombolysis In Myocardial Infarction flow 2 or 3 on CCAG and full contrast enhancement of the distal artery landmarks on MDCT. A final analysis was performed using 24 patients (312 segments). MDCT had a positive predictive value of 73.3% and a negative predictive value of 95.1% for detecting significant residual stenosis. It accurately estimated 17 of 18 patients (94.4%) with successful reperfusion and 5 of 6 (83.3%) with failed reperfusion on the basis of comparison with CCAG. Conclusions MDCT demonstrated high accuracy not only for the detecting residual stenosis, but also for assessing successful reperfusion after thrombolytic therapy in patients with STEMI. (Circ J 2006; 70: 1590 -1597)
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.70.1590