Department of Cardiology, Rabin Medical Center, Beilinson Campus, Petah Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Clin Cardiol. 2010 Feb;33(2):E39-43. doi: 10.1002/clc.20522.
More and more young people are being referred for evaluation or screening for coronary artery disease (CAD). However, the value of myocardial perfusion imaging (MPI) in this population is unclear, especially in the absence of symptoms.
The study sample included 1765 consecutive patients less than 51 years old who were referred to a major medical center for stress/rest MPI study. Clinical and MPI variables were compared between patients with and without known CAD, by gender.
There were 1346 (76%) men and 419 (24%) women of mean age 44 +/- 6 years; 461 (26%) had known CAD. Stress-induced ischemia was detected in 321 patients (18.2%) and significant ischemia in 131 (7.4%); there was no difference in the rate or severity of ischemia by presence of symptoms. Among those without known CAD, the rate of stress-induced ischemia by MPI was significantly lower in women than men. On logistic regression analysis, the independent predictors of ischemia in men were high cholesterol, diabetes, angina during stress testing, ST depression, and smoking (P<.0001); and in women, the independent predictors were diabetes and high cholesterol.
Known CAD and stress-induced ischemia are significantly more prevalent in young men than in young women, irrespective of risk factors. The independent predictors of ischemia differ between men and women.
越来越多的年轻人被推荐进行冠状动脉疾病（CAD）的评估或筛查。然而，在没有症状的情况下，MPI 在这一人群中的价值尚不清楚。
研究样本包括 1765 名年龄小于 51 岁的连续患者，他们被转介到一家主要医疗中心进行应激/静息 MPI 研究。通过性别比较了有和无已知 CAD 的患者之间的临床和 MPI 变量。
1346 名（76%）男性和 419 名（24%）女性，平均年龄为 44 +/- 6 岁；461 名（26%）有已知 CAD。321 名患者（18.2%）检测到应激诱导缺血，131 名（7.4%）有明显缺血；有症状的患者缺血的发生率和严重程度没有差异。在无已知 CAD 的患者中，女性 MPI 检测到的应激诱导缺血率明显低于男性。在逻辑回归分析中，男性缺血的独立预测因素是高胆固醇、糖尿病、应激试验时心绞痛、ST 压低和吸烟（P<.0001）；女性的独立预测因素是糖尿病和高胆固醇。
无论危险因素如何，年轻男性的已知 CAD 和应激诱导缺血明显比年轻女性更常见。缺血的独立预测因素在男性和女性之间有所不同。
