© 2014, American Society of Nuclear Cardiology. Background: The aim of this study was to analyze different prognoses in women and men with normal myocardial perfusion gated SPECT, according to stress test results. Methods: Differences between women and men in terms of hard events (HE) (non-fatal acute myocardial infarction or cardiac death) and HE plus coronary revascularization (HE + CR) were analyzed in 2,414 consecutive patients (mean age 62.8 ± 13.5 years, 1,438 women) with a normal stress-rest gated SPECT, taking into account their stress test results. Results: Four hundred and seven patients (16.9 %) (15.9 % women and 17.5 % men) had a positive stress test (ST-segment depression ≥1 mm and/or angina). During a follow-up of 5.1 ± 3.4 years, there were more significant HE (6.5 % vs 2.3 %; P = .005) and HE + CR (11.6 % vs 4.8 %, P = .001) in men with a positive stress test than in men with a negative stress test. These differences were not observed in women. In multivariate regression models, HE and HE + CR were also more frequent in men with a positive stress test (HR:3.3 [95 % CI 1.1 % to 9.5 %]; HR:4.2 [95 % CI 1.8 % to 9.9 %]; respectively) vs women with a positive stress test. Conclusions: Although patients with normal gated SPECT studies have a favorable outcome, men with an abnormal stress test have a more adverse prognosis than women.
- coronary angiography
- Normal single photon emission computed tomography
- positive stress test