Myocardial perfusion imaging in identifying a low-risk group after acute myocardial infarction

We conducted a prospective multicenter clinical trial, the Adenosine Sestamibi SPECT Post-Infarction Evaluation (INSPIRE) study, to define the use of adenosine myocardial perfusion imaging as an initial noninvasive method to assess risk after hospital admission and to help guide therapy in stable survivors of acute myocardial infarction. Adenosine imaging was able to define a low-risk group, which had the lowest rate of revascularization, the shortest hospital stay, the lowest hospital-related costs, and the lowest annual death or reinfarction event rate. Adenosine imaging also identified a large subset of subjects with scintigraphic scar who would unlikely benefit from coronary revascularization. The results of this study show that myocardial perfusion imaging as an initial test can be used to selectively triage patients to appropriate medical or revascularization therapies based on the scan results.