Independent and incremental prognostic value of exercise thallium single-photon emission computed tomographic imaging in women

✍ Scribed by Samir B. Pancholy; Alia Abdel Fattah; Abdalla M. Kamal; Massroor Ghods; Jaekyeong Heo; Abdulmassih S. Iskandrian

• Publisher: Springer
• Year: 1995
• Tongue: English
• Weight: 636 KB
• Volume: 2
• Category: Article
• ISSN: 1071-3581
• DOI: 10.1016/s1071-3581(95)80021-2

✦ Synopsis

Background:

This study examined the independent and incremental prognostic value of exercise thallium single-photon emission computed tomographic imaging in 212 women who also underwent coronary angiography.

Methods and results:

The left ventricular ejection fraction was normal (65% +/- 15%). during a mean follow-up of 40 months, 27 women had events (cardiac death or nonfatal myocardial infarction). univariate cox survival analysis showed several variables to be different between patients with events and those without events: age, exercise heart rate, the extent of coronary artery disease, reversible thallium defects, number of segments with reversible abnormality, and size of perfusion abnormality. multivariate survival analysis showed that a large perfusion abnormality and age were the independent predictors of events. actuarial life-table analysis showed that women with a large thallium abnormality (> or = 15% of the myocardium) had significantly worse event-free survival rates than had women with no or small abnormalities (mantel-cox statistic = 16; p = 0.0001).

Conclusions:

Thus exercise thallium-201 single-photon emission computed tomographic imaging provides independent and incremental prognostic information to clinical, exercise, and coronary angiographic results in women. the presence of a larger thallium abnormality identifies women at high risk of cardiac events.