Value of electrocardiographically gated single-photon emission computed tomographic myocardial perfusion scintigraphy in a cohort of symptomatic postmenopausal women.
The aim of this study is to prospectively evaluate the clinical value of electrocardiographically gated single-photon emission computed tomographic myocardial perfusion scintigraphy (MPS) imaging in a cohort of postmenopausal women with symptoms suggestive of ischemic heart disease. Forty-six postmenopausal women with no history of coronary artery disease (CAD), but with typical or atypical angina and >or=1 risk factor for CAD, were enrolled and underwent both coronary angiography and technetium-99m sestamibi MPS with exercise (n = 36) or pharmacologic stress (n = 10). All women were followed up for 5.0 +/- 3 years for the occurrence of hospitalization for acute coronary syndrome, myocardial infarction, and/or new-onset or worsening angina. CAD prevalence (>or=50% diameter stenosis) was 62% (26 of 42 patients). Fifteen patients (36%) had 1-vessel disease, 7 (17%) had 2-vessel disease, and 4 (10%) had 3-vessel disease. Diagnostic sensitivity and specificity of the exercise electrocardiogram were 67% and 69%, respectively. By comparison, sensitivity of MPS was 88% and specificity was 87.5% (p <0.0001). Cox survival analysis showed 3- and 5-year cumulative event-free survival rates of 97% and 94% for patients with normal MPS results compared with 60% and 48% for those with abnormal MPS findings (p <0.001). In conclusion, results of this study indicate high diagnostic and prognostic accuracy for MPS in symptomatic postmenopausal women.
Mieres
Jennifer H
JH
New York University School of Medicine, New York, USA. jennifer.mieres@med.nyu.edu
Makaryus
Amgad N
AN
Cacciabaudo
Jean M
JM
Donaldson
David
D
Green
Stephen J
SJ
Heller
Gary V
GV
Maddahi
Jamshid
J
Ong
Lawrence
L
Rampersaud
Tilkawatee
T
Rosen
Stacey E
SE
Shaw
Leslee J
LJ
Katz
Stanley
S
D000241:Adenosine; D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging; D015331:Cohort Studies; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology*; D003327:Coronary Disease / Q000175:diagnosis; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging*; D017698:Postmenopause / Q000502:physiology*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents
D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; D017256:Technetium Tc 99m Sestamibi; D000241:Adenosine