ABSTRACT
No data are available in Saudi Arabia on the relationship between coronary artery calcification [CAC] and myocardial perfusion scintigraphy [MPS] in asymptomatic women, for determining subclinical coronary artery disease [CAD]. The main objective of this study was to investigate the relationship between the presence of CAC and stress-induced myocardial ischemia by MPS in asymptomatic women. Single-center retrospective study over a 2-year period. One hundred and one women [mean [SD] age, 56 [11] years] without known CAD underwent both MPS and CAC scanning within 3 months. The frequency of ischemia by MPS was compared with the presence or absence of CAC and the number of CAD risk factors. The prevalence of ischemic MPS was 22% [22/101]. Among the 22 patients with ischemic MPS, the CAC score was 0 in 5 patients of 22 [23%], 1 to 200 in 4 patients of 22 [18%], and more than 200 in 13 patients of 22 [59%] [P=.0001]. In contrast, among the 79 patients with normal MPS, the CAC score was 0 in 44 of 79 [56%] patients, 1 to 200 in 25 of 79 [32%], and more than 200 in 10 of 79 [13%]. The presence or absence of CAC was the single most important predictor of the MPS result [P=.0001]. Moderate to severe CAC is associated with ischemic MPS in more than 50% of asymptomatic women with 2 or more CAD risk factors. Abnormal MPS is rarely associated with a 0 CAC score. Normal MPS does not exclude subclinical CAD. Therefore, CAC screening is an appropriate initial screening test for CAD in asymptomatic women