Significant association of female gender with lower degree of pathological 99mTc-sestamibi scintigraphy results as well as higher cardiac-related deaths free survival in elderly patients.
BACKGROUND
The aim of the present study was to assess the impact of female gender on the extent of myocardial perfusion defects as revealed by (99m)Tc-sestamibi myocardial perfusion scintigraphy (MPS) and on emerging cardiac events (CE) in patients aged ≥ 70 years.


METHODS
86 patients aged ≥ 70 years with known or suspected CAD undergoing MPS (74.4 ± 3.2 years; women: n = 46; 53.5%) were included in this study. Semiquantitative analysis of MPS was performed and summed stress (SSS), summed difference (SDS), and summed rest scores (SRS) were calculated. Emerging CE comprised myocardial revascularization and -infarction and cardiac-related death. Multivariate regression analysis was performed to assess the independent prognostic impact of several patient related variables on MPS results. Kaplan-Meier- and log rank analyses were calculated for assessment of CE free survival as related to gender.


RESULTS
Normal SSS (87.0% vs. 27.5%; p < 0.0001), SDS (80.4% vs. 27.5%; p < 0.0001), and SRS (97.8% vs. 82.5%; p = 0.023) were significantly more often found in women, whereas incidence of mildly and severely impaired SSS (6.5% vs. 35%; p = 0.001 and 2.2% vs. 25%; p = 0.002, respectively) and SDS (15.2% vs. 52.5%; p < 0.0001 and 2.2% vs. 17.5%; p = 0.023, respectively) were significantly higher in men. Multivariate logistic regression analysis revealed female gender as an independent predictor of normal SSS (odds ratio/OR: 17.6) and SDS (OR: 53.3). Female gender was associated with a significant higher cardiac-death free survival compared to male patients (p = 0.031).


CONCLUSIONS
Female gender is independently associated with a significantly lower degree of pathological MPS results and a higher cardiac-death free survival in elderly patients.
Department of Nuclear Medicine, University of Bonn, Bonn, Germany. jan.bucerius@ukb.uni-bonn.de
Jan
J
Bucerius
Alexius Y
AY
Joe
Ellen
E
Herder
Holger
H
Brockmann
Michael J
MJ
Reinhardt
Holger
H
Palmedo
Klaus
K
Tiemann
Hans-Jürgen
HJ
Biersack
D000368:Aged; D002423:Cause of Death; D001026:Coronary Artery Bypass / Q000401:mortality*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality*; D023381:Endpoint Determination; D005080:Exercise Test / Q000706:statistics & numerical data; D005260:Female; D005858:Germany; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality*; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000401:mortality*; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D017256:Technetium Tc 99m Sestamibi
D017256:Technetium Tc 99m Sestamibi
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