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(Circulation. 2000;101:1643.)
© 2000 American Heart Association, Inc.

Brief Rapid Communications

Identification of Coronary Thrombus With a IIb/IIIa Platelet Inhibitor Radiopharmaceutical, Technetium-99m DMP-444

A Canine Model

Joseph Mitchel, DO; David Waters, MD; Tianjie Lai, MD; Michael White, CNMT; Tod Alberghini, BS; Ahmad Salloum, MD; David Knibbs, PhD; Dadong Li, MD; Gary V. Heller, MD, PhD

From the Nuclear Cardiology and Cardiac Catheterization Laboratories, Division of Cardiology, Hartford Hospital, Hartford, Conn, and the University of Connecticut School of Medicine, Farmington, Conn.

Correspondence to Joseph Mitchel, DO, Cardiac Catheterization Laboratory, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102-5037. E-mail: Jmitche{at}harthosp.org

Background—A diagnostic test that could distinguish between stable and unstable coronary atherosclerotic plaques would be useful. We tested the ability of a new glycoprotein IIb/IIIa platelet inhibitor DMP-444, labeled with technetium (Tc)-99 m, to identify platelet-rich thrombus by nuclear imaging in a canine model.

Methods and Results—Combinations of a flow-limiting stenosis and 0 to 15 minutes of endothelial electrical stimulation at a site in the left anterior descending coronary artery were used to induce varying amounts of thrombus formation. In 10 animals with markedly positive nuclear images after the injection of Tc-99m DMP-444, the presence of platelet-rich thrombus was confirmed postmortem by gross appearance, high nuclear counts, and abundant platelets on electron microscopy. The 10 animals with negative images had lower counts, smaller thrombus weights (P<0.05 for each), and fewer platelets by electron microscopy.

Conclusions—Activated platelets participating in acute thrombus formation can be accurately detected by nuclear imaging using Tc-99 m DMP-444.

Key Words: diagnosis • imaging • platelet aggregation inhibitors • thrombosis

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