Original ArticlesAccuracy of dipyridamole SPECT imaging in identifying individual coronary stenoses and multivessel disease in women versus men☆,☆☆
Section snippets
Methods
Prospectively collected databases of consecutive unselected patients undergoing stress myocardial perfusion imaging at two university-affiliated hospitals (collected for 3 years at one hospital and for more than 1 year at the other hospital) were queried, and men and women who had undergone dipyridamole stress Tc-99m sestamibi myocardial perfusion imaging within 6 months of coronary angiography were identified. All patients with an intervening interventional procedure and patients with earlier
Patients
The baseline characteristics of the 107 patients (58 women and 49 men) are detailed in Table 1.
Empty Cell Women (n = 58) Men (n = 49) Age (years) 68.2 ± 10.1 67.8 ± 8.8 Primary indication for test Known or suspected CAD 44 (76) 39 (80) Recent MI 6 (10) 5 (10) Preoperative assessment 8 (14) 5 (10) Pre-test likelihood of CAD < 20% 13 (22) 9 (18) 20% to 80% 19 (33) 11 (22) > 80% 2 (45) 29 (59) Risk factors for CAD DM 22 (38) 19 (39) Smoking 15 (26) 15 (31) Lipids 24 (41) 12 (24) Family history 24 (41) 11 (22)
Discussion
The diagnostic accuracy of dipyridamole myocardial perfusion imaging in detecting coronary artery disease has been well documented in the literature. In a review written by Leppo 10 years ago, the combined sensitivity and specificity values from the published reports were 90% and 70%, respectively.11 Many studies used planar imaging techniques. More recent papers reporting SPECT imaging with either thallium-201 or Tc-99m sestamibi have also documented high sensitivities for the detection of
References (30)
Diagnosis and risk stratification in coronary artery disease: Nuclear cardiology versus stress echocardiography
J Nucl Cardiol
(1997)- et al.
Lower diagnostic accuracy of thal-lium-201 SPECT myocardial perfusion imaging in women: An effect of smaller chamber size
J Am Coll Cardiol
(1996) - et al.
Adenosine tech-netium-99m sestamibi myocardial perfusion SPECT in women: Diagnostic efficacy in detection of coronary artery disease
J Am Coll Cardiol
(1996) - et al.
Comparative diagnostic accuracy of Tl-201 and Tc-99m sestamibi SPECT imaging (perfusion and ECG-Gated SPECT) in detecting coronary artery disease in women
J Am Coll Cardiol
(1997) - et al.
Effective risk stratification using exercise myocardial perfusion SPECT in women: Gender related differences in prognostic nuclear testing
J Am Coll Cardiol
(1996) - et al.
Relation of gender to physician use of test results and to the prognostic value of stress technetium-99m sestamibi myocardial single-photon emission computed tomography scintigraphy
Am Heart J
(1997) - et al.
Patterns of coronary heart disease morbidity and mortality in the sexes. A 26-year follow-up of the Framingham population
Am Heart J
(1986) - et al.
Dipyridamole-induced ST segment depression during thallium-201 imaging in patients with coronary artery disease: Angiographic and hemodynamic determinants
J Am Coll Cardiol
(1988) - et al.
Dobutamine stress echocardiography in women with chest pain
J Am Coll Cardiol
(1999) - et al.
Prevalence of high-risk thallium-201 scintigraphic findings in left main coronary artery stenosis: Comparison with patients with multi-ple-and single-vessel coronary artery disease
Am J Cardiol
(1984)
Noninvasive identification of severe coronary artery disease using exercise tomographic thallium-201 imaging
Am J Cardiol
Identification of severe and extensive coronary artery disease by automatic measurement of transient ischemic dilation of the left ventricle in dual-isotope myocardial perfusion SPECT
J Am Coll Cardiol
Increased stress right ventricular activity on dual isotope perfusion SPECT. A sign of multivessel and/or left main coronary artery disease
J Am Coll Cardiol
Identification of high-risk patients with left main and three-vessel coronary artery disease by adenosine-single photon emission computed tomographic thallium imaging
Am Heart J
Noninvasive identification of left main and triple vessel coronary artery disease: Improved accuracy using quantitative analysis of regional myocardial stress distribution and washout of thallium-201
J Am Coll Cardiol
Cited by (0)
- ☆
Reprint requests: Mark I. Travin, MD, Department of Nuclear Medicine, Montefiore Medical Center, 111 East 210th St, Bronx, NY 10467-2490.
- ☆☆
J Nucl Cardiol 2000;7:213–20.