Objective: To assess the diagnostic efficacy of stress myocardial perfusion imaging (MPI) in female coronary artery disease (CAD) patients.
Methods: Two hundred and fifty-nine consecutive female patients, aged 60 +/- 8, underwent stress myocardial perfusion single photon emission computed tomography (SPECT) imaging and coronary angiography with an interval of < 60 days. Among them, 227 patients underwent exercise MPI, injected intravenously with (99m)Tc-methoxyisobutyl isonitrile (MIBI) 740 - 925 MBq when the exercise end point was reached, and 32 patients underwent pharmacologic stress MPI, injected intravenously with persantine or adenosine and then (99m)Tc-MIBI.
Results: Among the 227 patients undergoing exercise MPI 79 had significant coronary artery stenosis with the overall sensitivity and specificity for detecting coronary artery disease of 63% and 97% respectively. According to the exercise heart rate, the 227 patients were divided into two groups: group 1 (n = 137) the patients of which achieved adequate exercise end points, and group 2 (n = 90) the patients of which only reached submaximal exercise. The sensitivity of exercise MPI for detecting CAD was 86% in the group 1 and 38% in the group 2. Among the 32 patients who underwent pharmacologic stress MPI 13 had significant CAD with the sensitivity and specificity of 85% and 84% respectively.
Conclusion: Stress MPI is an efficient protocol for the detection of CAD in women, and pharmacologic stress MPI is more suitable for the women with decreased exercise capacity and advanced age.