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:	R Medicine (General)
Online Access:	http://eprints.usm.my/46643/1/DR%20SITI%20NOORAEIN%20YASER_HJ.pdf
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id	my-usm-ep.46643
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spelling	my-usm-ep.466432020-06-29T07:43:53Z Baseline Technetium-99m Tetrofosmin Myocardial Perfusion Study In Predicting The Management Outcome Of Patients With Newly Diagnosed Myocardial Infarction 2019 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 http://eprints.usm.my/46643/ http://eprints.usm.my/46643/1/DR%20SITI%20NOORAEIN%20YASER_HJ.pdf application/pdf en public masters Universiti Sains Malaysia Institut Perubatan & Pergigian Termaju
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	R Medicine (General)
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
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.
format	Thesis
qualification_level	Master's degree
author	Yaser, Siti Nooraein
author_facet	Yaser, Siti Nooraein
author_sort	Yaser, Siti Nooraein
title	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_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_sort	baseline technetium-99m tetrofosmin myocardial perfusion study in predicting the management outcome of patients with newly diagnosed myocardial infarction
granting_institution	Universiti Sains Malaysia
granting_department	Institut Perubatan & Pergigian Termaju
publishDate	2019
url	http://eprints.usm.my/46643/1/DR%20SITI%20NOORAEIN%20YASER_HJ.pdf
_version_	1747821703297236992

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

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