MYOCARDIAL REPERFUSION IN THROMBOLYSIS-A TC-99(M)-SESTAMIBI SPECT STUDY IN PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION

This study presents the outcome of myocardial scintigraphy performed before and after thrombolytic treatment in 16 patients with acute myocardial infarction using Tc-99(m)-Sestamibi (Cardiolite(R), Du Pont Scandinavia AB, Kista, Sweden). The patients were given Tc-99(m)-Sestamibi intravenously as soon as possible after the decision to give thrombolytic treatment. When the patients were in a clinically stable state after the thrombolytic treatment, myocardial perfusion was analysed with the gamma camera using single photon emission computerized tomography (SPECT). A second Tc-99(m)-Sestamibi tomography was carried out on the second to fourth day after the myocardial infarction. Data reconstruction was done with the 'Bull's eye technique'. Nine patients received thrombolysis < 3 h from the onset of pain. In this group six patients (66%) improved their myocardial perfusion by > 10% after treatment, while all seven patients who received treatment greater-than-or-equal-to 3 h after the onset of pain improved their myocardial perfusion by < 10%. This study emphasises the importance of early diagnosis and treatment of patients with acute myocardial infarction in order to salvage myocardium.