Published in:
01-06-2015 | Original Article
Normal Myocardial Perfusion Gated SPECT and Positive Stress Test: Different Prognoses in Women and Men
Published in: Journal of Nuclear Cardiology | Issue 3/2015
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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.