Identification of extensive coronary artery disease in women by exercise single-photon emission computed tomographic (SPECT) thallium imaging.
OBJECTIVE
The aim of this study was to examine the ability of exercise single-photon emission computed tomographic (SPECT) thallium imaging to identify high risk women with left main or three-vessel coronary artery disease using a stepwise discriminant analysis.


BACKGROUND
Previous studies have used statistical methods to identify high risk men with coronary artery disease. Only limited data are available in women.


METHODS
Exercise SPECT thallium imaging and coronary arteriography were performed for evaluation of chest pain in 243 women. Group 1 comprised 58 women with left main or three-vessel coronary disease and group 2 comprised 185 women with no or one- or two-vessel disease. Stepwise discriminant analysis was used to determine predictors of left main or three-vessel disease.


RESULTS
On univariate analysis, women in group 1 were older (p < 0.03) and had a lower exercise work load (p < 0.02), lower exercise heart rate (p < 0.004), higher prevalence rate of diabetes mellitus (p < 0.0003) and more multivessel thallium abnormality (p < 0.0001) compared with women in group 2. On multivariate analysis, only multivessel thallium abnormality (F = 43) and exercise heart rate (F = 6) were independent predictors of left main or three-vessel coronary disease. A model based on these two variables separated the women into three risk groups: 99 patients with 9%, 70 patients with 23% and 74 patients with 45% prevalence of left main or three-vessel disease (p < 0.0001).


CONCLUSIONS
High risk women with left main or three-vessel coronary disease can be identified by exercise SPECT thallium imaging.
Chae
S C
SC
Philadelphia Heart Institute, Presbyterian Medical Center, Pennsylvania 19104.
Heo
J
J
Iskandrian
A S
AS
Wasserleben
V
V
Cave
V
V
D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D016002:Discriminant Analysis; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D012680:Sensitivity and Specificity; D012737:Sex Factors; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D013794:Thallium Radioisotopes