Baseline Technetium-99m Tetrofosmin Myocardial Perfusion Study In Predicting The Management Outcome Of Patients With Newly Diagnosed Myocardial Infarction

Background: Thrombolytic therapy is one of the treatment modality in ST elevation myocardial infarction (STEMI) although percutaneous coronary intervention (PCI) is an established gold standard treatment. Myocardial Perfusion Study (MPS) is one of the diagnostic modalities that can be used for ri...

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Main Author: Yaser, Siti Nooraein
Format: Thesis
Language:English
Published: 2019
Subjects:
Online Access:http://eprints.usm.my/46643/
http://eprints.usm.my/46643/1/DR%20SITI%20NOORAEIN%20YASER_HJ.pdf
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author Yaser, Siti Nooraein
author_facet Yaser, Siti Nooraein
author_sort Yaser, Siti Nooraein
building USM Institutional Repository
collection Online Access
description Background: Thrombolytic therapy is one of the treatment modality in ST elevation myocardial infarction (STEMI) although percutaneous coronary intervention (PCI) is an established gold standard treatment. Myocardial Perfusion Study (MPS) is one of the diagnostic modalities that can be used for risk stratification post STEMI. The purpose of this research is to study the role of MPS in predicting the management outcome in newly diagnosed STEMI patients. Methods: Post STEMI with thrombolytic treatment referred for MPS were included in this study. MPS findings including semi quantitative analysis of severity of ischaemia, automated summed difference score (SDS), left ventricular ejection fraction (LVEF), end diastolic volume (EDV) and end systolic volume (ESV) were obtained. Follow up was done 12 months after baseline MPS. Primary outcome on types of management with secondary outcome were studied in relation to MPS findings. Results: Seven patients had encountered cardiac hard events 12 months after the baseline MPS. All were male with mean age of 54.3 years old. Analysis of MPS findings and primary outcome found that moderate to severe ischemia, SDS of 5 - 6 (OR = 49.875; 95% CI 11.30 – 220.16), SDS of ≥7 (OR = 39.35; 95% CI 10.51 – 147.35), and LVEF ≥35% had significant unadjusted increased chance for revascularisation. Moderate to severe ischemia (OR = 285.8; 95% CI 28.15 - 2902.08) and LVEF ≥ 35%(OR = 54.04; 95% CI 6.10 – 478.56) had significant increased chance for revascularisation when adjusted to other confounding factors in multivariate analysis. Meanwhile LVEF of 23.7% with range 17-29% (OR = 0.593; 95% CI 0.39 – 0.9), EDV of 172.6 ml with range 155-197 mls (OR = 1.13; 95% CI 1.05 – 1.21), and ESV of 130.9 ml with range 110-141 mls (OR = 1.16; 95% CI 1.03 –1.31) had significant unadjusted increased chance of cardiac hard events.
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spelling usm-466432020-06-29T07:43:53Z http://eprints.usm.my/46643/ Baseline Technetium-99m Tetrofosmin Myocardial Perfusion Study In Predicting The Management Outcome Of Patients With Newly Diagnosed Myocardial Infarction Yaser, Siti Nooraein R Medicine (General) Background: Thrombolytic therapy is one of the treatment modality in ST elevation myocardial infarction (STEMI) although percutaneous coronary intervention (PCI) is an established gold standard treatment. Myocardial Perfusion Study (MPS) is one of the diagnostic modalities that can be used for risk stratification post STEMI. The purpose of this research is to study the role of MPS in predicting the management outcome in newly diagnosed STEMI patients. Methods: Post STEMI with thrombolytic treatment referred for MPS were included in this study. MPS findings including semi quantitative analysis of severity of ischaemia, automated summed difference score (SDS), left ventricular ejection fraction (LVEF), end diastolic volume (EDV) and end systolic volume (ESV) were obtained. Follow up was done 12 months after baseline MPS. Primary outcome on types of management with secondary outcome were studied in relation to MPS findings. Results: Seven patients had encountered cardiac hard events 12 months after the baseline MPS. All were male with mean age of 54.3 years old. Analysis of MPS findings and primary outcome found that moderate to severe ischemia, SDS of 5 - 6 (OR = 49.875; 95% CI 11.30 – 220.16), SDS of ≥7 (OR = 39.35; 95% CI 10.51 – 147.35), and LVEF ≥35% had significant unadjusted increased chance for revascularisation. Moderate to severe ischemia (OR = 285.8; 95% CI 28.15 - 2902.08) and LVEF ≥ 35%(OR = 54.04; 95% CI 6.10 – 478.56) had significant increased chance for revascularisation when adjusted to other confounding factors in multivariate analysis. Meanwhile LVEF of 23.7% with range 17-29% (OR = 0.593; 95% CI 0.39 – 0.9), EDV of 172.6 ml with range 155-197 mls (OR = 1.13; 95% CI 1.05 – 1.21), and ESV of 130.9 ml with range 110-141 mls (OR = 1.16; 95% CI 1.03 –1.31) had significant unadjusted increased chance of cardiac hard events. 2019 Thesis NonPeerReviewed application/pdf en http://eprints.usm.my/46643/1/DR%20SITI%20NOORAEIN%20YASER_HJ.pdf Yaser, Siti Nooraein (2019) Baseline Technetium-99m Tetrofosmin Myocardial Perfusion Study In Predicting The Management Outcome Of Patients With Newly Diagnosed Myocardial Infarction. Masters thesis, Universiti Sains Malaysia.
spellingShingle R Medicine (General)
Yaser, Siti Nooraein
Baseline Technetium-99m Tetrofosmin Myocardial Perfusion Study In Predicting The Management Outcome Of Patients With Newly Diagnosed Myocardial Infarction
title Baseline Technetium-99m Tetrofosmin Myocardial Perfusion Study In Predicting The Management Outcome Of Patients With Newly Diagnosed Myocardial Infarction
title_full Baseline Technetium-99m Tetrofosmin Myocardial Perfusion Study In Predicting The Management Outcome Of Patients With Newly Diagnosed Myocardial Infarction
title_fullStr Baseline Technetium-99m Tetrofosmin Myocardial Perfusion Study In Predicting The Management Outcome Of Patients With Newly Diagnosed Myocardial Infarction
title_full_unstemmed Baseline Technetium-99m Tetrofosmin Myocardial Perfusion Study In Predicting The Management Outcome Of Patients With Newly Diagnosed Myocardial Infarction
title_short Baseline Technetium-99m Tetrofosmin Myocardial Perfusion Study In Predicting The Management Outcome Of Patients With Newly Diagnosed Myocardial Infarction
title_sort baseline technetium-99m tetrofosmin myocardial perfusion study in predicting the management outcome of patients with newly diagnosed myocardial infarction
topic R Medicine (General)
url http://eprints.usm.my/46643/
http://eprints.usm.my/46643/1/DR%20SITI%20NOORAEIN%20YASER_HJ.pdf