Predictors of Abnormal Stress Myocardial Perfusion Scan

ORIGINAL RESEARCH, October 2018, VOL V ISSUE IV
10.5083/ejcm.20424884.158 , Cite or Link Using DOI
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Ahmed Goha, Kenechukwu Mezue, Filipa Alves, Kristofer C. Madu, Paul Edwards, Felix Nunura, Dainia S. Baugh, Edwin Tulloch-Reid, Marshall Tulloch-Reid, Ernest C. Madu

ABSTRACT

Aims: Cardiovascular disease is the leading cause of death in Jamaica. The aim of this study was to recognize the independent predictors of coronary artery disease (CAD) detected by stress myocar- dial perfusion imaging (MPI), and identify the predictive ability of MPI in detecting significant CAD in a Caribbean population who were referred to a cardiology clinic in Jamaica.

Methods: Retrospective analysis of a cohort of 202 patients who had a stress MPI from 2015-2016. Ninety-one patients underwent symptom-limited treadmill stress MPI, one hundred and nine pa- tients had dobutamine stress MPI and two patients had adenosine stress test.

Results: Exercise stress testing showed a significantly higher hemodynamic response compared to dobutamine stress test (p 0.00034), though there was no significant correlation between the type of stress and test results (p 0.077). Logistic regression model demonstrated that age (odds ratio 1.043; p=0.08), male gender (odds ratio, 0.34; P = .006) and history of hypertension (odds ratio, 0.046 p value 0.0001) were significant independent predictors of a positive MPI. Twenty one patients with abnormal MPI had invasive coronary angiography. The predictive ability of abnormal vascular territory perfusion to correlate with assigned coronary artery was 64.3%, while the predic- tive ability of abnormal MPI to detect CAD was 95.2%.

Conclusion: The prevalence of abnormal myocardial perfusion findings is relatively greater in el- derly, male and hypertensive Caribbean patients with high probability of significant CAD. There- fore, MPI scan may be advocated in assessment workup of patients with presumed greater prob- ability of CAD.