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  • Title: Identification of extensive coronary artery disease in women by exercise single-photon emission computed tomographic (SPECT) thallium imaging.
    Author: Chae SC, Heo J, Iskandrian AS, Wasserleben V, Cave V.
    Journal: J Am Coll Cardiol; 1993 May; 21(6):1305-11. PubMed ID: 8473634.
    Abstract:
    OBJECTIVES: The aim of this study was to examine the ability of exercise single-photon emission computed tomographic (SPECT) thallium imaging to identify high risk women with left main or three-vessel coronary artery disease using a stepwise discriminant analysis. BACKGROUND: Previous studies have used statistical methods to identify high risk men with coronary artery disease. Only limited data are available in women. METHODS: Exercise SPECT thallium imaging and coronary arteriography were performed for evaluation of chest pain in 243 women. Group 1 comprised 58 women with left main or three-vessel coronary disease and group 2 comprised 185 women with no or one- or two-vessel disease. Stepwise discriminant analysis was used to determine predictors of left main or three-vessel disease. RESULTS: On univariate analysis, women in group 1 were older (p < 0.03) and had a lower exercise work load (p < 0.02), lower exercise heart rate (p < 0.004), higher prevalence rate of diabetes mellitus (p < 0.0003) and more multivessel thallium abnormality (p < 0.0001) compared with women in group 2. On multivariate analysis, only multivessel thallium abnormality (F = 43) and exercise heart rate (F = 6) were independent predictors of left main or three-vessel coronary disease. A model based on these two variables separated the women into three risk groups: 99 patients with 9%, 70 patients with 23% and 74 patients with 45% prevalence of left main or three-vessel disease (p < 0.0001). CONCLUSIONS: High risk women with left main or three-vessel coronary disease can be identified by exercise SPECT thallium imaging.
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