TY - JOUR
T1 - Value of Electrocardiographically Gated Single-Photon Emission Computed Tomographic Myocardial Perfusion Scintigraphy in a Cohort of Symptomatic Postmenopausal Women
AU - Mieres, Jennifer H.
AU - Makaryus, Amgad N.
AU - Cacciabaudo, Jean M.
AU - Donaldson, David
AU - Green, Stephen J.
AU - Heller, Gary V.
AU - Maddahi, Jamshid
AU - Ong, Lawrence
AU - Rampersaud, Tilkawatee
AU - Rosen, Stacey E.
AU - Shaw, Leslee J.
AU - Katz, Stanley
N1 - Funding Information:
This study was supported in part by an unrestricted research grant from Bristol Meyers-Squibb Medical Imaging. The work was performed at a single center: North Shore University Hospital, Manhasset, New York.
PY - 2007/4/15
Y1 - 2007/4/15
N2 - The aim of this study is to prospectively evaluate the clinical value of electrocardiographically gated single-photon emission computed tomographic myocardial perfusion scintigraphy (MPS) imaging in a cohort of postmenopausal women with symptoms suggestive of ischemic heart disease. Forty-six postmenopausal women with no history of coronary artery disease (CAD), but with typical or atypical angina and ≥1 risk factor for CAD, were enrolled and underwent both coronary angiography and technetium-99m sestamibi MPS with exercise (n = 36) or pharmacologic stress (n = 10). All women were followed up for 5.0 ± 3 years for the occurrence of hospitalization for acute coronary syndrome, myocardial infarction, and/or new-onset or worsening angina. CAD prevalence (≥50% diameter stenosis) was 62% (26 of 42 patients). Fifteen patients (36%) had 1-vessel disease, 7 (17%) had 2-vessel disease, and 4 (10%) had 3-vessel disease. Diagnostic sensitivity and specificity of the exercise electrocardiogram were 67% and 69%, respectively. By comparison, sensitivity of MPS was 88% and specificity was 87.5% (p <0.0001). Cox survival analysis showed 3- and 5-year cumulative event-free survival rates of 97% and 94% for patients with normal MPS results compared with 60% and 48% for those with abnormal MPS findings (p <0.001). In conclusion, results of this study indicate high diagnostic and prognostic accuracy for MPS in symptomatic postmenopausal women.
AB - The aim of this study is to prospectively evaluate the clinical value of electrocardiographically gated single-photon emission computed tomographic myocardial perfusion scintigraphy (MPS) imaging in a cohort of postmenopausal women with symptoms suggestive of ischemic heart disease. Forty-six postmenopausal women with no history of coronary artery disease (CAD), but with typical or atypical angina and ≥1 risk factor for CAD, were enrolled and underwent both coronary angiography and technetium-99m sestamibi MPS with exercise (n = 36) or pharmacologic stress (n = 10). All women were followed up for 5.0 ± 3 years for the occurrence of hospitalization for acute coronary syndrome, myocardial infarction, and/or new-onset or worsening angina. CAD prevalence (≥50% diameter stenosis) was 62% (26 of 42 patients). Fifteen patients (36%) had 1-vessel disease, 7 (17%) had 2-vessel disease, and 4 (10%) had 3-vessel disease. Diagnostic sensitivity and specificity of the exercise electrocardiogram were 67% and 69%, respectively. By comparison, sensitivity of MPS was 88% and specificity was 87.5% (p <0.0001). Cox survival analysis showed 3- and 5-year cumulative event-free survival rates of 97% and 94% for patients with normal MPS results compared with 60% and 48% for those with abnormal MPS findings (p <0.001). In conclusion, results of this study indicate high diagnostic and prognostic accuracy for MPS in symptomatic postmenopausal women.
UR - http://www.scopus.com/inward/record.url?scp=34147172937&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2006.12.024
DO - 10.1016/j.amjcard.2006.12.024
M3 - Article
C2 - 17437734
AN - SCOPUS:34147172937
SN - 0002-9149
VL - 99
SP - 1096
EP - 1099
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 8
ER -