Gated SPECT Evaluation of Outcome After Abciximab-Supported Primary Infarct Artery Stenting for Acute Myocardial Infarction: The Scintigraphic Data of the Abciximab and Carbostent Evaluation (ACE) Randomized Trial

Journal of Nuclear Medicine

Alberto Pupi¹  David Antoniucci¹  Renato Valenti¹  Guido Parodi¹  Gentian Memisha¹  Roberto Sciagr๠ Giovanni Maria Santoro¹  Angela Migliorini¹  Guia Moschi¹ 

关键词: acute myocardial infarction;    angioplasty;    gated SPECT;    stenting;   

DOI  :  

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

We used gated SPECT to evaluate the impact of abciximab on the efficacy of myocardial reperfusion in patients with acute myocardial infarction undergoing infarct-related artery stenting. Methods: The Abciximab and Carbostent Evaluation (ACE) trial randomized 400 infarct patients to stenting alone or stenting plus abciximab. One-month 99mTc-sestamibi gated SPECT was planned in a subgroup of consecutive patients to evaluate infarct size, infarct severity, left ventricular volumes, and ejection fraction. Results: The final study population included 182 patients (99 randomized to abciximab and 83 to stenting alone). Gated SPECT revealed smaller infarcts in the abciximab group than in the stenting-alone group (14.3% ± 11.7% vs. 18.1% ± 13%, P < 0.02), and lower infarct severity (minimum-to-maximum count ratio = 0.47 ± 0.17 vs. 0.41 ± 0.15, P < 0.02), resulting in a smaller left ventricular end-diastolic volume index (57.8 ± 20.0 vs. 64.6 ± 20.8 mL/m2, P = 0.03) and left ventricular end-systolic volume index (31.7 ± 17.4 vs. 37.5 ± 18.6 mL/m2, P = 0.05) in the abciximab group. One-month left ventricular ejection fraction was significantly higher in patients randomized to abciximab (47.4% ± 11.3% vs. 43.9% ± 11.7%, P = 0.05). Conclusion: The use of abciximab therapy as an adjunct to infarct-related artery stenting leads to a reduction in infarct size and severity, resulting in smaller 1-mo left ventricular volumes and better left ventricular function. Gated SPECT appears to be an ideal tool for outcome assessment in infarct patients undergoing different treatment strategies.

【 授权许可】

Unknown