title: Independent and incremental prognostic value of exercise thallium single-photon emission computed tomographic imaging in women.
abstract: BACKGROUND
  This study examined the independent and incremental prognostic value of exercise thallium single-photon emission computed tomographic imaging in 212 women who also underwent coronary angiography.
  
  
  RESULTS
  The left ventricular ejection fraction was normal (65% +/- 15%). During a mean follow-up of 40 months, 27 women had events (cardiac death or nonfatal myocardial infarction). Univariate Cox survival analysis showed several variables to be different between patients with events and those without events: age, exercise heart rate, the extent of coronary artery disease, reversible thallium defects, number of segments with reversible abnormality, and size of perfusion abnormality. Multivariate survival analysis showed that a large perfusion abnormality and age were the independent predictors of events. Actuarial life-table analysis showed that women with a large thallium abnormality (> or = 15% of the myocardium) had significantly worse event-free survival rates than had women with no or small abnormalities (Mantel-Cox statistic = 16; p = 0.0001).
  
  
  CONCLUSIONS
  Thus exercise thallium-201 single-photon emission computed tomographic imaging provides independent and incremental prognostic information to clinical, exercise, and coronary angiographic results in women. The presence of a larger thallium abnormality identifies women at high risk of cardiac events.
authors.affiliation: Philadelphia Heart Institute, Presbyterian Medical Center, PA 19104, USA.
authors.forename: S B
authors.initials: SB
authors.lastname: Pancholy
authors.forename: A A
authors.initials: AA
authors.lastname: Fattah
authors.forename: A M
authors.initials: AM
authors.lastname: Kamal
authors.forename: M
authors.initials: M
authors.lastname: Ghods
authors.forename: J
authors.initials: J
authors.lastname: Heo
authors.forename: A S
authors.initials: AS
authors.lastname: Iskandrian
mesh_terms: D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000401:mortality; D005080:Exercise Test; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D013794:Thallium Radioisotopes