Normal Myocardial Perfusion Gated SPECT and Positive Stress Test: Different Prognoses in Women and Men

J Nucl Cardiol. 2015 Jun;22(3):453-65. doi: 10.1007/s12350-014-0009-z. Epub 2014 Oct 29.

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.

MeSH terms

  • Age Factors
  • Aged
  • Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography*
  • Coronary Angiography
  • Death
  • Exercise Test*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Revascularization
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Sex Factors