Imaging and echocardiographyAdenosine single photon emission computed tomography for assessing risk after myocardial infarction: recent developmentsDorfman, Todd A; Iskandrian, Ami E Author Information Division of Cardiovascular Disease, University of Alabama, Birmingham, Alabama, USA Correspondence to Todd A. Dorfman, MD, Division of Cardiovascular Diseases, The University of Alabama, Birmingham, LHRB 306, 1530 3rd Avenue S, Birmingham AL 35294-0007 Tel: +1 205 934 0820; fax: +1 205 975 8568; e-mail: [email protected] Current Opinion in Cardiology: September 2007 - Volume 22 - Issue 5 - p 401-407 doi: 10.1097/HCO.0b013e32820652c9 Buy Metrics Abstract Purpose of review While the prognostic power of adenosine single photon emission computed tomography myocardial perfusion imaging has been validated in multiple patient populations including those with known or suspected coronary artery disease, the utility of this modality in assessing risk after an acute myocardial infarction in the primary angioplasty era is still a topic of debate. Recent findings The INSPIRE trial showed that early adenosine single photon emission computed tomography myocardial perfusion imaging is capable of identifying low-risk patients for early hospital discharge after acute myocardial infarction. This novel study demonstrated that intensive medical therapy is a reasonable strategy in low, intermediate, and high-risk post-myocardial infarction patients with preserved left ventricular function. Summary The INSPIRE trial established the role for early adenosine single photon emission computed tomography myocardial perfusion imaging as a tool for risk stratification in stable patients after an acute myocardial infarction and provided evidence that intensive medical therapy is comparable to coronary revascularization in suppressing ischemia and presumably improving cardiac outcomes. It remains to be seen whether these new findings will alter current American College of Cardiology/American Heart Association guidelines, which emphasize a primary role of coronary revascularization in acute coronary syndromes. © 2007 Lippincott Williams & Wilkins, Inc.