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Gender differences in the diagnostic accuracy of SPECT myocardial perfusion imaging: A bivariate meta-analysis

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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

It remains controversial whether the diagnostic accuracy of single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI) is different in men as compared to women. We performed a meta-analysis to investigate gender differences of SPECT MPI for the diagnosis of CAD (≥50% stenosis).

Method

Two investigators independently performed a systematic review of the MEDLINE and EMBASE databases from inception through January 2012 for English-language studies determining the diagnostic accuracy of SPECT MPI. We included prospective studies that compared SPECT MPI with conventional coronary angiography which provided sufficient data to calculate gender-specific true and false positives and negatives. Data from studies evaluating <20 patients of one gender were excluded. Bivariate meta-analysis was used to create summary receiver operating curves.

Results

Twenty-six studies met inclusion criteria, representing 1,148 women and 1,142 men. Bivariate meta-analysis yielded a mean sensitivity and specificity of 84.2% (95% confidence interval [CI] 78.7%-88.6%) and 78.7% (CI 70.0%-85.3%) for SPECT MPI in women and 89.1% (CI 84.0%-92.7%) and 71.2% (CI 60.8%-79.8%) for SPECT MPI in men. There was no significant difference in the sensitivity (P = .15) or specificity (P = .23) between male and female subjects.

Conclusion

In a bivariate meta-analysis of the available literature, the diagnostic accuracy of SPECT MPI is similar for both men and women.

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Disclosures

Dr Heller serves on the Scientific Advisory Board of Lantheus Medical Imaging. The remaining authors have no disclosures relevant to this project.

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Authors and Affiliations

  1. Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA

    Aline Iskandar MD, Matthew W. Parker MD & Gary V. Heller MD, PhD

  2. University of Connecticut School of Pharmacy, Storrs, CT, USA

    Brendan Limone PharmD, Andrew Perugini PharmD, Hyejin Kim PharmD, Charles Jones PharmD, Brian Calamari PharmD & Craig I. Coleman PharmD

  3. Division of Cardiology, Henry Low Heart Center, Hartford Hospital, 80 Seymour Street, Hartford, CT, 06102, USA

    Aline Iskandar MD, Matthew W. Parker MD & Gary V. Heller MD, PhD

  4. Hartford Hospital Evidence Based Practice Center, Hartford, CT, USA

    Craig I. Coleman PharmD

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  1. Aline Iskandar MD
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Correspondence to Aline Iskandar MD.

Additional information

This project was supported by an independent investigator-initiated research grant from Lantheus Medical Imaging, Billerica, MA.

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Iskandar, A., Limone, B., Parker, M.W. et al. Gender differences in the diagnostic accuracy of SPECT myocardial perfusion imaging: A bivariate meta-analysis. J. Nucl. Cardiol. 20, 53–63 (2013). https://doi.org/10.1007/s12350-012-9646-2

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