The relationship between coronary artery calcification and myocardial perfusion in asymptomatic women.
OBJECTIVE
No data are available in Saudi Arabia on the relationship between coronary artery calcification (CAC) and myocardial perfusion scintigraphy (MPS) in asymptomatic women, for determining subclinical coronary artery disease (CAD). The main objective of this study was to investigate the relationship between the presence of CAC and stress-induced myocardial ischemia by MPS in asymptomatic women.


METHODS
Single-center retrospective study over a 2-year period.


METHODS
One hundred and one women (mean [SD] age, 56 [11] years) without known CAD underwent both MPS and CAC scanning within 3 months. The frequency of ischemia by MPS was compared with the presence or absence of CAC and the number of CAD risk factors.


RESULTS
The prevalence of ischemic MPS was 22% (22/101). Among the 22 patients with ischemic MPS, the CAC score was 0 in 5 patients of 22 (23%), 1 to 200 in 4 patients of 22 (18%), and more than 200 in 13 patients of 22 (59%) (P=.0001). In contrast, among the 79 patients with normal MPS, the CAC score was 0 in 44 of 79 (56%) patients, 1 to 200 in 25 of 79 (32%), and more than 200 in 10 of 79 (13%). The presence or absence of CAC was the single most important predictor of the MPS result (P=.0001).


CONCLUSIONS
Moderate to severe CAC is associated with ischemic MPS in more than 50% of asymptomatic women with 2 or more CAD risk factors. Abnormal MPS is rarely associated with a 0 CAC score. Normal MPS does not exclude subclinical CAD. Therefore, CAC screening is an appropriate initial screening test for CAD in asymptomatic women.
Imaging Service, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. ahm35799@hotmail.com
Ahmed
A
Fathala
Ali
A
Al Amer
Mohamed
M
Shukri
Mohei M
MM
Abouzied
Abdulaziz
A
Alsugair
D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000175:diagnosis* / Q000473:pathology; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000473:pathology; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000473:pathology; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index