Myocardial perfusion profile in a young population with and without known coronary artery disease: comparison by gender.
BACKGROUND
More and more young people are being referred for evaluation or screening for coronary artery disease (CAD). However, the value of myocardial perfusion imaging (MPI) in this population is unclear, especially in the absence of symptoms.


METHODS
The study sample included 1765 consecutive patients less than 51 years old who were referred to a major medical center for stress/rest MPI study. Clinical and MPI variables were compared between patients with and without known CAD, by gender.


RESULTS
There were 1346 (76%) men and 419 (24%) women of mean age 44 +/- 6 years; 461 (26%) had known CAD. Stress-induced ischemia was detected in 321 patients (18.2%) and significant ischemia in 131 (7.4%); there was no difference in the rate or severity of ischemia by presence of symptoms. Among those without known CAD, the rate of stress-induced ischemia by MPI was significantly lower in women than men. On logistic regression analysis, the independent predictors of ischemia in men were high cholesterol, diabetes, angina during stress testing, ST depression, and smoking (P<.0001); and in women, the independent predictors were diabetes and high cholesterol.


CONCLUSIONS
Known CAD and stress-induced ischemia are significantly more prevalent in young men than in young women, irrespective of risk factors. The independent predictors of ischemia differ between men and women.
Zafrir
Nili
N
Department of Cardiology, Rabin Medical Center, Beilinson Campus, Petah Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. zafrirmd@isdn.net.il
Mats
Israel
I
Solodky
Alejandro
A
Kornowski
Ran
R
Sulkes
Jaqueline
J
Battler
Alexander
A
D000328:Adult; D000367:Age Factors; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D003326:Coronary Circulation; D004176:Dipyridamole; D025401:Echocardiography, Stress; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D055414:Myocardial Perfusion Imaging / Q000379:methods; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D017256:Technetium Tc 99m Sestamibi; D013793:Thallium; D015899:Tomography, Emission-Computed, Single-Photon; D014665:Vasodilator Agents
D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; D004176:Dipyridamole; D017256:Technetium Tc 99m Sestamibi; D013793:Thallium