Thrombolysis in anterior myocardial infarction: effect on regional viability studied with positon emission tomography

in Circulation (1987), 76(suppl.IV), 5

Complementary role of thallium-201 scintigraphy to predischarge exercise electrocardiography for patients stratification after a first myocardial infarction.

in European Heart Journal (1986), 7(8), 644-53726

The value of a predischarge exercise test combined with thallium-201 myocardial scintigraphy in detecting patients with severe multivessel disease (MVD) was studied in 58 consecutive patients discharged ... [more ▼]

The value of a predischarge exercise test combined with thallium-201 myocardial scintigraphy in detecting patients with severe multivessel disease (MVD) was studied in 58 consecutive patients discharged after a first acute myocardial infarction. Twelve electrocardiographic, clinical and scintigraphic variables were analysed. Angiography at one month revealed MVD (greater than 70% narrowing in vessels unrelated to infarction) in 26 patients (45%). ST segment depression of 1mm or greater, thallium defects in multiple vascular distributions (MVTL), and reversible thallium defects in a vascular distribution different from the infarct related vessel predicted patients at risk for MVD (predictive value respectively of 68%, 65% and 75%). The other variables were not significantly associated with the presence of MVD. Only ST segment depression and thallium defects in multiple vascular distributions emerged as independent predictors of MVD. Their combination yielded a 77% sensitivity and a 59% specificity for MVD. Combination of thallium imaging with the predischarge exercise ECG significantly improved the stratification provided by the exercise test alone (P less than 0.05). A positive thallium scan (MVTl defects) associated with a positive ECG (ST depression) carried a risk for MVD of 80% in the population studied. When both tests were negative, MVD was infrequent (risk 22%). Because improvement in the stratification of patients is not as clear as expected from studies performed at a later stage, it appears that exercise thallium scintigraphy at a submaximal level one or two weeks after infarction does not provide optimal information. Predischarge exercise thallium-201 scintigraphy, however, is superior to an exercise tolerance test alone in separating patients into those with high and low risk of MVD. [less ▲]

Contribution de la Chimie clinique au diagnostic et au pronostic et au pronostic de l'infarctus du myocarde

Poster (1985, October 29)

Computerization and routine use of dynamic risk index for acute myocardial infarction patients

Conference (1985, August)

On the interpretation of serial laboratory measurements in acute myocardial infarction.

in Clinical Chemistry (1984), 30(1), 69-76

Serial laboratory determinations are now routinely performed on patients admitted to intensive-care units. Adequate interpretation of such cumulative information for clinical decision-making purposes is a ... [more ▼]

Serial laboratory determinations are now routinely performed on patients admitted to intensive-care units. Adequate interpretation of such cumulative information for clinical decision-making purposes is a challenging problem. We describe a statistical method for predicting--sequentially as the data become available--the patient's outcome, death or survival. Thus, the method goes beyond previously reported techniques that base such prediction on only a single multivariate observation. The method has been applied to daily measurements of serum urea and lactate dehydrogenase, performed during one week on patients hospitalized in the coronary-care unit with acute myocardial infarction. Two baseline variables were also included in the dynamic risk index so derived: the age of the patient and the number of previous myocardial infarctions recorded on admission. We also discuss the problems of selecting the most-predictive laboratory tests and of determining for each test the amount of past data needed to achieve satisfactory prediction. We distinguish between global evaluation of the dynamic risk index obtained (in terms of specificity and sensitivity) and individual interpretation (in terms of posterior/prior probability ratio) of a given risk score for a particular patient. The approach described may contribute to more effective use of results of repeated laboratory tests on critically ill patients. [less ▲]

Continuous risk assessment using serial data in patients with myocardial infarction

in European Heart Journal Supplements : Journal of the European Society of Cardiology (1983), 4(Suppl. E), 61

Th long-term prognostic significance of biochemical measurements obtained during the acute phase of myocardial infarction

Conference (1982, September)

Continuous assessment of risk using a dynamic prognostic index in patients with myocardial infarction

Poster (1982, August)

Serum myoglobin determinations in the assessment of acute myocardial infarction.

in European Heart Journal (1982), 3(2), 122-129

Critical evaluation of serum uric acid levels in acute myocardial infarction.

in Clinica Chimica Acta (1982), 121(2), 147-157

Serial measurements of serum uric acid were performed on patients suffering from acute myocardial infarction. Nearly 80 percent of the cases demonstrated a fall in uric acid concentrations during the ... [more ▼]

Serial measurements of serum uric acid were performed on patients suffering from acute myocardial infarction. Nearly 80 percent of the cases demonstrated a fall in uric acid concentrations during the first two days of hospitalization and a subsequent return to initial levels within six to eight days. There was a relationship between the decrease in uric acid levels and the serum lactate dehydrogenase activity. No evidence could be found that male patients were hyperuricemic as compared to control subjects. However, female patients between 40 and 60 years of age demonstrated significantly higher uric acid levels than healthy women of corresponding ages, even after adjustment for diuretic use. [less ▲]