Stress perfusion cardiac MRI in women

Abstract

Women had a similar number of risk factors to Men (2.3 ± 1.2, p = ns), but were significantly older (67.4 vs 64 yrs, p<0.001). They were also more likely to have diabetes (28.7% vs 25.4%, p=0.02) but less likely to smoke (17.2% vs 30.9%, p <0.001). In relation to previous cardiac history, women were less likely to have had PCI (19.1& vs 33.3%, p < 0.001), coronary artery bypass grafting, or myocardial infarction ((7.1& vs 16.3% , p< 0.001). Women have less ischemia (12.42% vs 21.79, p<0.001) but a similar likelihood of infarct (25.20% vs 23.74%, p = 0.29). Asymptomatic women had less ischemia than asymptomatic male (12.0% vs 21.5%, p<0.001). Symptomatic women had less ischemia than asymptomatic Men (13.0% vs 21.45%, p<0.001). Asymptomatic and symptomatic women have similar rates of ischemia (12.0% vs 13.0%, p = 0.575). Conclusion In spite of a similar risk profile to men, they have much less ischemia on testing. The incidence of myocardial infarction is similar in both men and women in this population suspected of coronary artery disease. The presence of symptoms, either chest pain or shortness of breath, does not increase the likelihood of ischemia in women. Myocardial infarction not related to epicardial artery stenoses may play a role in explaining the presence of chest pain in women with normal coronary arteries.