Assessing coronary artery disease with thallium-201 rest and technetium-99m-sestamibi stress testing at two centers

In this study we assessed the specific location(s) of cardiac wall abnormalities in a population of patients referred for coronary artery disease and compared gender differences in the interpretation of nuclear medicine rest/stress results.

The study group consisted of 846 patients referred to 2 nuclear medicine outpatient cardiology centers for assessment between November 1998 and April 1999. All patients received dual-isotope perfusion 201Tl rest/99mTc-sestamibi stress tests. A retrospective analysis of patient results was performed.

In both facilities the largest percentage of defects was identified in the inferior wall (35.5%), followed by the anterior wall (26.5%). Cardiac defects identified in 3 other walls were much lower: lateral wall (14.2%), septal (13.8%), and apical (9.5%). In both outpatient clinics the normalcy rate was much higher for women than men. The normalcy rate in men was 40%, whereas women demonstrated a normalcy rate of 60%. An analysis of treadmill stress versus pharmacologic stress did not illuminate the cause of this difference.

The most common site of myocardial wall abnormalities occurred in the inferior wall followed by the anterior wall. A large disparity was identified between the results for men compared with those for women. Men had nearly twice the number of defects as women in this study.