Multidetector row computed tomography noninvasively assesses coronary reperfusion after thrombolytic therapy in patients with ST elevation myocardial infarction. |
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Authors: | Dong Il Shin Yoo Dong Won Kiyuk Chang Woo Seung Pum Joon Kim Yun Jung Park Hae Ok Jung Hee Kyung Jeon Sang Hong Baek Wook Sung Chung Ki Tae Kim Youn-Jeong Kim Ki-Bae Seung |
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Institution: | Department of Internal Medicine, The catholic University of Korea, Seoul, South Korea. |
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Abstract: | BACKGROUND: The 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 infarct-related 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. |
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