Independent and incremental prognostic value of exercise thallium single-photon emission computed tomographic imaging in women.
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.
Pancholy
S B
SB
Philadelphia Heart Institute, Presbyterian Medical Center, PA 19104, USA.
Fattah
A A
AA
Kamal
A M
AM
Ghods
M
M
Heo
J
J
Iskandrian
A S
AS
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
D013794:Thallium Radioisotopes