Original articlesComparison between Tc-99m N-NOET and Tl-201 in the assessment of patients with known or suspected coronary artery disease
Section snippets
Patient selection
Patients with known or suspected CAD scheduled for coronary angiography were prospectively studied as part of a European multicenter study. Myocardial infarction in the preceding 8 weeks, percutaneous coronary intervention in the preceding 3 months, or coronary artery bypass surgery in the preceding 6 months were exclusion criteria. In addition, pregnant or lactating women, as well as any patient with standard contraindications to exercise testing (unstable angina, severe aortic stenosis,
Results
Of the 58 patients who participated in the United Kingdom arm of the study, 50 underwent both Tl-201 and Tc-99m N-NOET exercise-redistribution and reinjection studies. Baseline characteristics are shown in Table 1. The majority of patients (84%) were taking aspirin at baseline, together with 58% taking β-blockers and 26% taking rate-limiting calcium antagonists. This reflected the high prevalence of CAD in our study population. Of the patients, 48 (96%) underwent Tl-201 SPECT imaging followed
Discussion
Tc-99m N-NOET is a new neutral, lipophilic, technetium-based complex that demonstrates high myocardial uptake in animal models.13 In canine models myocardial regional distribution with Tc-99m N-NOET has correlated well with regional blood flow (when assessed with microspheres) over a large range of coronary flows.9 Unlike other technetium-based agents, it does not plateau at higher coronary flows and hence behaves much more like Tl-201. Other characteristics such as a high first-pass extraction
Acknowledgment
We thank CIS-Bio International (Schering, Gif-sur-Yvette, France) for providing the Tc-99m N-NOET used in this study as well as for their ongoing help and support.
The authors have indicated they have no financial conflicts of interest.
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