Chae S C, Heo J, Iskandrian A S, Wasserleben V, Cave V
Philadelphia Heart Institute, Presbyterian Medical Center, Pennsylvania 19104.
J Am Coll Cardiol. 1993 May;21(6):1305-11. doi: 10.1016/0735-1097(93)90301-g.
The aim of this study was to examine the ability of exercise single-photon emission computed tomographic (SPECT) thallium imaging to identify high risk women with left main or three-vessel coronary artery disease using a stepwise discriminant analysis.
Previous studies have used statistical methods to identify high risk men with coronary artery disease. Only limited data are available in women.
Exercise SPECT thallium imaging and coronary arteriography were performed for evaluation of chest pain in 243 women. Group 1 comprised 58 women with left main or three-vessel coronary disease and group 2 comprised 185 women with no or one- or two-vessel disease. Stepwise discriminant analysis was used to determine predictors of left main or three-vessel disease.
On univariate analysis, women in group 1 were older (p < 0.03) and had a lower exercise work load (p < 0.02), lower exercise heart rate (p < 0.004), higher prevalence rate of diabetes mellitus (p < 0.0003) and more multivessel thallium abnormality (p < 0.0001) compared with women in group 2. On multivariate analysis, only multivessel thallium abnormality (F = 43) and exercise heart rate (F = 6) were independent predictors of left main or three-vessel coronary disease. A model based on these two variables separated the women into three risk groups: 99 patients with 9%, 70 patients with 23% and 74 patients with 45% prevalence of left main or three-vessel disease (p < 0.0001).
High risk women with left main or three-vessel coronary disease can be identified by exercise SPECT thallium imaging.
本研究旨在通过逐步判别分析，检验运动单光子发射计算机断层扫描（SPECT）铊成像识别患有左主干或三支冠状动脉疾病的高危女性的能力。
既往研究已使用统计方法识别患有冠状动脉疾病的高危男性。关于女性的数据有限。
对243名女性进行运动SPECT铊成像和冠状动脉造影以评估胸痛情况。第1组包括58名患有左主干或三支冠状动脉疾病的女性，第2组包括185名无或患有单支或两支血管疾病的女性。采用逐步判别分析来确定左主干或三支血管疾病的预测因素。
单因素分析显示，与第2组女性相比，第1组女性年龄更大（p < 0.03）、运动负荷更低（p < 0.02）、运动心率更低（p < 0.004）、糖尿病患病率更高（p < 0.0003）以及多支血管铊异常更多（p < 0.0001）。多因素分析显示，只有多支血管铊异常（F = 43）和运动心率（F = 6）是左主干或三支冠状动脉疾病的独立预测因素。基于这两个变量的模型将女性分为三个风险组：99名患者左主干或三支血管疾病患病率为9%，70名患者为23%，74名患者为45%（p < 0.0001）。
运动SPECT铊成像可识别患有左主干或三支冠状动脉疾病的高危女性。
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