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

Abstract

BackgroundThe 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 infarctrelated 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

Assessing Culprit Lesions and Active Complex Lesions in Patients With Early Acute Myocardial Infarction by Multidetector Computed Tomography

“…7 Furthermore, MDCT has been shown to be safe and accurate in assessing the severity of the infarct-related artery and the number of diseased vessels during the first week after AMI. [8][9][10][11] However, there is scarce published data on plaque texture evaluated by 64-slice MDCT in patients early after AMI. In this prospective study, we focus on MDCT to predict culprit lesions and identify multiple complex lesions in patients early after first AMI.…”