PMID- 10608589
OWN - NLM
STAT- MEDLINE
DCOM- 20000107
LR  - 20191103
IS  - 1071-3581 (Print)
IS  - 1071-3581 (Linking)
VI  - 6
IP  - 6
DP  - 1999 Nov-Dec
TI  - Acipimox does not augment thallium-201 redistribution in the fasting state.
PG  - 620-5
AB  - BACKGROUND: Recently oral glucose loading and a thallium-glucose insulin infusion 
      have been used to augment myocardial uptake of thallium-201 (TI-201). Acipimox is 
      a nicotinic-acid derivative that reduces serum free fatty acid (FFA) levels and 
      enhances myocardial glucose uptake. This study was performed to assess the 
      effects of acipimox on TI-201 redistribution. METHODS: Fourteen patients with 
      coronary artery disease underwent 2 successive TI-201 perfusion studies. Stress 
      was performed by adenosine coupled with ergometer exercise. Patients received 
      either 500 mg of acipimox or placebo immediately after stress, and images were 
      acquired. Redistribution imaging was carried out after 4 hours. Patients returned 
      after 7 to 14 days for a repeat stress protocol, receiving the alternate test 
      article. Both studies were carried out under identical conditions with identical 
      medication with the patient in the fasting state. Image analysis was conducted 
      quantitatively with polar plots and by using segmental uptake as a percentage of 
      maximal counts with a 9-segment model. RESULTS: There were no significant 
      differences between the acipimox and placebo arms of the study of hemodynamic 
      parameters. On polar plot analysis, there were no differences between acipimox 
      and placebo for mean values of stress defect extent (97 +/- 16.1 vs 96.5 +/- 18.8 
      pixels), defect severity (532.2 +/- 120 vs 537 +/- 133.9 standard deviations 
      [SDs]), for defect reversibility (61.7 +/- 18 vs 55.4 +/- 15.3 SDs), and 
      percentage reversibility (21.2% +/- 5.5% vs 19.2% +/- 5.8%), respectively. 
      Similarly, on segmental uptake analysis there was no significant difference 
      between the acipimox and placebo arms with regard to the proportion of segments 
      classified as normal, fixed defect, reversible defect, or reverse redistribution. 
      CONCLUSION: Although acipimox has been shown to augment myocardial glucose uptake 
      and myocardial glucose uptake has been shown to improve cellular uptake of 
      TI-201, in the fasting state acipimox does not enhance the redistribution after 
      stress. This may be because serum insulin levels are not increased by acipimox, 
      and insulin is instrumental in enhancing the joint transport of glucose and 
      TI-201 into myocytes.
FAU - Gunning, M G
AU  - Gunning MG
AD  - Institute of Nuclear Medicine, University College London Medical School 
      Department of Nuclear Medicine, United Kingdom.
FAU - Clunie, G
AU  - Clunie G
FAU - Yepes-Mora, S
AU  - Yepes-Mora S
FAU - Eastick, S
AU  - Eastick S
FAU - Underwood, S R
AU  - Underwood SR
FAU - Bomanji, J
AU  - Bomanji J
FAU - Ell, P J
AU  - Ell PJ
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Nucl Cardiol
JT  - Journal of nuclear cardiology : official publication of the American Society of 
      Nuclear Cardiology
JID - 9423534
RN  - 0 (Hypolipidemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Pyrazines)
RN  - 0 (Radiopharmaceuticals)
RN  - 0 (Thallium Radioisotopes)
RN  - 0 (Vasodilator Agents)
RN  - IY9XDZ35W2 (Glucose)
RN  - K72T3FS567 (Adenosine)
RN  - K9AY9IR2SD (acipimox)
SB  - IM
MH  - Adenosine
MH  - Administration, Oral
MH  - Adult
MH  - Aged
MH  - Coronary Disease/diagnostic imaging/metabolism
MH  - Cross-Over Studies
MH  - Double-Blind Method
MH  - Exercise Test
MH  - Fasting/*metabolism
MH  - Female
MH  - Glucose/administration & dosage/metabolism
MH  - Heart/*diagnostic imaging
MH  - Humans
MH  - Hypolipidemic Agents/administration & dosage/*pharmacology
MH  - Insulin/administration & dosage
MH  - Male
MH  - Middle Aged
MH  - Myocardial Ischemia/diagnostic imaging/metabolism
MH  - Myocardium/*metabolism
MH  - Prospective Studies
MH  - Pyrazines/administration & dosage/*pharmacology
MH  - Radiopharmaceuticals/*pharmacokinetics
MH  - Thallium Radioisotopes/*pharmacokinetics
MH  - *Tomography, Emission-Computed, Single-Photon
MH  - Vasodilator Agents
EDAT- 1999/12/23 00:00
MHDA- 1999/12/23 00:01
CRDT- 1999/12/23 00:00
PHST- 1999/12/23 00:00 [pubmed]
PHST- 1999/12/23 00:01 [medline]
PHST- 1999/12/23 00:00 [entrez]
AID - S1071-3581(99)90099-5 [pii]
AID - 10.1016/s1071-3581(99)90099-5 [doi]
PST - ppublish
SO  - J Nucl Cardiol. 1999 Nov-Dec;6(6):620-5. doi: 10.1016/s1071-3581(99)90099-5.