title: Normal Myocardial Perfusion Gated SPECT and Positive Stress Test: Different Prognoses in Women and Men.
abstract: BACKGROUND
  The aim of this study was to analyze different prognoses in women and men with normal myocardial perfusion gated SPECT, according to stress test results.
  
  
  METHODS
  Differences between women and men in terms of hard events (HE) (non-fatal acute myocardial infarction or cardiac death) and HE plus coronary revascularization (HE + CR) were analyzed in 2,414 consecutive patients (mean age 62.8 ± 13.5 years, 1,438 women) with a normal stress-rest gated SPECT, taking into account their stress test results.
  
  
  RESULTS
  Four hundred and seven patients (16.9%) (15.9% women and 17.5% men) had a positive stress test (ST-segment depression ≥1 mm and/or angina). During a follow-up of 5.1 ± 3.4 years, there were more significant HE (6.5% vs 2.3%; P = .005) and HE + CR (11.6% vs 4.8%, P = .001) in men with a positive stress test than in men with a negative stress test. These differences were not observed in women. In multivariate regression models, HE and HE + CR were also more frequent in men with a positive stress test (HR:3.3 [95% CI 1.1% to 9.5%]; HR:4.2 [95% CI 1.8% to 9.9%]; respectively) vs women with a positive stress test.
  
  
  CONCLUSIONS
  Although patients with normal gated SPECT studies have a favorable outcome, men with an abnormal stress test have a more adverse prognosis than women.
authors.affiliation: Cardiology Department, Hospital Universitari Vall d'Hebron, Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d'Hebron 119-129, Barcelona, 08035, Spain, guirom@adinet.com.uy.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Romero-Farina
authors.forename: Jaume
authors.initials: J
authors.lastname: Candell-Riera
authors.forename: Ignacio
authors.initials: I
authors.lastname: Ferreira-González
authors.forename: Santiago
authors.initials: S
authors.lastname: Aguadé-Bruix
authors.forename: Nazarena
authors.initials: N
authors.lastname: Pizzi
authors.forename: David
authors.initials: D
authors.lastname: García-Dorado
mesh_terms: D000367:Age Factors; D000368:Aged; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; D017023:Coronary Angiography; D003643:Death; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000000981:diagnostic imaging; D009204:Myocardial Revascularization; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012737:Sex Factors