Introduction: Coronary artery disease is the leading cause of mortality in the general population. Women constitute a special group of patients due to the fact that clinical presentation in women is less characteristic and diagnostic tests are more difficult to interpret. The representation by men in clinical trials grossly exceeds that by women and the number of investigations conducted selectively in women remains too small. The aim of this study was to evaluate the diagnostic usefulness of myocardial perfusion scintigraphy (SPS) with 99mTc-MIBI in women with suspected coronary artery disease, particularly in those with nondiagnostic or positive stress electrocardiography (SEKG), to assess the prognostic value of SPS during a 4-year follow-up targeting serious cardiac events, and to compare the results of SPS with SEKG and coronary angiography.
Material and methods: We enrolled 230 women with a moderate probability of coronary artery disease estimated on the basis of clinical scales and SEKG. A 2-day stress/ rest SPS was done in all patients. The clinical course was determined in 157 patients. It was found that the 1-year risk of a serious cardiac event in women with an abnormal SPS was 7.9%, as opposed to 1.7% in women with a normal SPS.
Result: The results confirmed the high prognostic value of SPS in predicting serious cardiac events (p = 0.01). There was no statistically significant correlation between ambulant SEKG and SPS (p = 0.06). Similarly, the results of SEKG did not correlate with serious cardiac events (p = 0.35). The prognostic value of SPS found by us was high, and moreover, SPS turned out to be superior over SEKG in our study group.
Conclusion: Myocardial perfusion scintigraphy emerged as a good diagnostic tool in women with suspected coronary artery disease. Myocardial perfusion scintigraphy is helpful in verifying the need for further diagnostic tests in women, especially with positive or nondiagnostic SEKG.