Elsevier

Journal of Nuclear Cardiology

Volume 7, Issue 3, May–June 2000, Pages 213-220
Journal of Nuclear Cardiology

Original Articles
Accuracy of dipyridamole SPECT imaging in identifying individual coronary stenoses and multivessel disease in women versus men,☆☆

Presented in part at the Forty-fifth Annual Scientific Session of the American College of Cardiology, March 1996, Orlando, Fla.
https://doi.org/10.1016/S1071-3581(00)70009-2Get rights and content

Abstract

Background. Older women frequently undergo dipyridamole perfusion imaging and can have advanced coronary artery disease, but little data exist on the accuracy of perfusion imaging in detecting disease in individual vascular territories and multivessel disease in women, compared with men. Methods and Results. From a database of patients undergoing myocardial single photon emission computed tomography (SPECT) perfusion imaging, 107 unselected sequential patients (58 women, 49 men) who underwent sestamibi dipyridamole stress and cardiac catheterization within 6 months of each other were identified. Data were analyzed to compare sensitivities for detection of individual coronary stenoses and multivessel disease. The concordance between perfusion image results and cardiac catheterization for individual coronary territories for women was 75%, and for men, it was 65% (P = .09). In women, the presence of disease of the left anterior descending coronary artery was detected more frequently than it was in men, 84% versus 44% (P = .004). The detection of disease in the territories of the left circumflex and right coronary arteries was similar for both groups. For women, the accuracy of perfusion imaging in identifying the presence/absence of multivessel coronary disease was 64%, compared with 71% for men (P = not significant). Conclusions. The accuracy of dipyridamole sestamibi SPECT imaging in detecting multi-vessel disease was similar for men and women. The sensitivity of dipyridamole sestamibi SPECT imaging in detecting disease of the left anterior descending artery was better in women. (J Nucl Cardiol 2000;7:213–20.)

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.

. Baseline characteristics of patients

Empty CellWomen (n = 58)Men (n = 49)
Age (years)68.2 ± 10.167.8 ± 8.8
Primary indication for test
 Known or suspected CAD44 (76)39 (80)
 Recent MI6 (10)5 (10)
 Preoperative assessment8 (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
 DM22 (38)19 (39)
 Smoking15 (26)15 (31)
 Lipids24 (41)12 (24)
 Family history24 (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)

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.

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