Gender differences in the accuracy of stress 99mTc-sestamibi myocardial perfusion imaging

Deepa Kumar, Ravinder S Sethi, Sandeep Bansal, Padma A Namgyal, Aditi K Sehgal, Tajamul S Malik

Astrocyte 2016 3(3):131-136

Introduction: Coronary artery disease (CAD) is a leading cause of death in both women and men worldwide. There is under-recognition and under-diagnosis of CAD as a cause of high mortality rates in women. There is paucity of data regarding comparison of sensitivity, specificity, and accuracy of myocardial perfusion imaging-single photon emission computed tomography (MPI-SPECT) study in women and men in Indian population. Hence, this study was carried out to compare the sensitivity, specificity, and accuracy of MPI in women and men in the Indian population. Material and Methods: This retrospective study included 275 patients, 49 women and 226 men. Only patients who had coronary angiography (CAG) done within 6 months of the stress 99mTc-sestamibi MPI-SPECT study were included in the study. Two arbitrary cut-off points on CAG, i.e., ≥50% and ≥70% were used for the determination of extent of CAD. Results: Considering CAG as the gold standard with ≥50% coronary stenosis as the cut-off criteria for significant stenosis, the overall sensitivity, specificity, and accuracy, respectively, of MPI- SPECT was 80%, 65%, and 72% in women and 82%, 70%, and 76% in men (P value not significant). Considering ≥70% coronary stenosis as the cut off criteria for significant stenosis, the overall sensitivity, specificity, and accuracy, respectively, of MPI-SPECT was 88%, 57%, and 66% in women and 87%, 59%, and 70% in men (P value not significant). No significant difference was found in the sensitivity, specificity, and accuracy of left anterior descending, left circumflex artery, and right coronary artery coronary vessels among women and men for both ≥50% and ≥70% coronary stenosis as the cut off criteria. Conclusion: 99mTc-sestamibi MPI-SPECT has comparable sensitivity, specificity, and accuracy for the detection of CAD in women as it does in men.

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