The accuracy of myocardial perfusion SPECT imaging in the evaluation of coronary artery disease in women and men.
BACKGROUND
The purpose of this study is to compare sensitivity, specificity and accuracy of myocardial perfusion SPECT for the detection of coronary artery disease (CAD) in women and men.


METHODS
588 patients (455 males and 133 females, 273 after a previous myocardial infarction) underwent stress myocardial perfusion SPECT. The accuracy of myocardial perfusion SPECT was proved by coronary angiography (stenosis > 50% was considered as a CAD).


RESULTS
The sensitivity of SPECT was slightly higher, but statistically not significant, in men than in women (94% versus 91%, p > 0.05). The specificity was higher in women than in men (93% versus 82%), but this difference was not statistically significant either (p > 0.05). The accuracy of SPECT was the same for both sexes (92%). In angiographically verified group of patients the selection bias was obvious--patients with CAD dominated (74%) and the fraction of patients with CAD in men's group (83%) was significantly higher than in women's group (50%), p < 0.05.


CONCLUSIONS
No significant difference was revealed in the accuracy of myocardial perfusion SPECT in men and women. Our results are in accordance with the prevailing opinion in literature that discovered differences in sensitivity, specificity and diagnostic accuracy are usually not statistically significant or that they can be explained by the selection bias of patients in angiographically verified groups (significantly higher fraction of patients with CAD in men's group).
Department of Nuclear Medicine, University Hospital, Olomouc, Czech Republic. milan.kaminek@fnol.cz
M
M
Kamínek
M
M
Myslivecek
V
V
Husák
P
P
Koranda
M
M
Skvarilová
J
J
Ostransky
O
O
Lang