Abnormal technetium-99m pyrophosphate images in unstable angina

Ischemia versus infarction?

Allan S Jaffe, Milton S. Klein, Bharti R. Patel, Barry A. Siegel, Robert Roberts

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

There is controversy concerning the specificity of myocardial infarct imaging with technetium-99m pyrophosphate due to the high frequency of false positive images, especially in patients with unstable angina. In this study technetium-99m pyrophosphate images were compared with frequent determinations of plasma creatine kinase, MB isoenzyme (MB CK) activity in 116 patients admitted with the diagnosis of unstable angina. It was hypothesized that frequent measurement of MB CK activity, a sensitive and specific marker for myocardial necrosis, using sensitive assay techniques would detect small amounts of myocardial necrosis which might have been unrecognized by conventional clinical methods. The scintigraphic results and isoenzyme determinations agreed in 88 percent of patients; both tests were normal in 69 percent and both were abnormal, indicating acute myocardial infarction, in 19 percent of patients. In the remaining 14 patients (12 percent), the scans were abnormal, but MB CK activity was normal. In five of these patients (4 percent), abnormal scintigrams presumably reflected persistent scan positivity after previous myocardial infarction. Only the remaining nine patients (8 percent) could be classified as having unexplained false positive scans, a frequency substantially less than that reported by other investigators who based the diagnosis of myocardial infarction on conventional clinical criteria. These results suggest that abnormal technetium-99m pyrophosphate images in patients with unstable angina generally indicate myocardial necrosis.

Original languageEnglish (US)
Pages (from-to)1035-1039
Number of pages5
JournalThe American Journal of Cardiology
Volume44
Issue number6
DOIs
StatePublished - 1979
Externally publishedYes

Fingerprint

Technetium
Unstable Angina
Infarction
Ischemia
Myocardial Infarction
Necrosis
Isoenzymes
MB Form Creatine Kinase
diphosphoric acid
Research Personnel

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Abnormal technetium-99m pyrophosphate images in unstable angina : Ischemia versus infarction? / Jaffe, Allan S; Klein, Milton S.; Patel, Bharti R.; Siegel, Barry A.; Roberts, Robert.

In: The American Journal of Cardiology, Vol. 44, No. 6, 1979, p. 1035-1039.

Research output: Contribution to journalArticle

Jaffe, Allan S ; Klein, Milton S. ; Patel, Bharti R. ; Siegel, Barry A. ; Roberts, Robert. / Abnormal technetium-99m pyrophosphate images in unstable angina : Ischemia versus infarction?. In: The American Journal of Cardiology. 1979 ; Vol. 44, No. 6. pp. 1035-1039.
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