Gender Disparities, Temporal Trends and Cardiovascular Outcomes in Patients with Angina Undergoing SPECT Stress Test

Authors

David Ricardo Murillo-Garcia, Cardiovascular Medicine Fellowship, Reading Hospital-Tower Health, West Reading, PAFollow
Christopher Reggio, Cardiovascular Medicine Fellowship, Reading Hospital-Tower Health, West Reading, PAFollow
Nandini Razdan, Cardiovascular Medicine Fellowship, Reading Hospital-Tower Health, West Reading, PAFollow
Adam Feldman, Department of Medicine, Division of Cardiology, Reading Hospital - Tower Health, West Reading, PAFollow
Aniruddha Singh, Cardiovascular Medicine Fellowship, Reading Hospital-Tower Health, West Reading, PAFollow

Document Type

Abstract

Publication Date

8-1-2025

Abstract

Introduction: Disparities in the use of imaging modalities like SPECT stress testing may impact outcomes across patient groups. This study assessed gender-based differences in SPECT use and cardiovascular outcomes in angina patients. Methods: This retrospective cohort study used real-world data from 55 healthcare organizations via the TriNetX Global Health Research Collaborative Network. Adults (>18 years) diagnosed with angina between April 2015 and April 2025 were included. Patients with prior coronary artery disease or incomplete data were excluded. Gender-based subcohorts were created. Propensity score matching adjusted for demographic and clinical factors. Kaplan-Meier survival analyses, log-rank tests, and Cox proportional hazards models compared outcomes. Primary outcomes were SPECT stress test utilization and a composite of myocardial infarction and ischemic cardiomyopathy. Treatment pathways mapped diagnostic and therapeutic decisions. Results: A total of 1,683,492 patients were included. Of these, 66.8% of males and 67.9% of females underwent SPECT stress testing (HR 0.96; 95% CI: 0.95-0.97; p< 0.0001), with consistent yearly trends. After angina diagnosis, the most frequent tests were SPECT with treadmill (47.3%), treadmill alone (27.4%), and coronary angiography (16%). These proportions were consistent across gender subgroups. Males had a significantly higher incidence of the composite outcome of myocardial infarction and ischemic cardiomyopathy (HR 1.28; 95% CI: 1.25-1.31; p< 0.0001). Discussion: SPECT with treadmill stress testing was the most common used diagnostic tool following angina diagnosis. There was slightly lower use among males with higher incidence of adverse outcomes. These findings highlight the importance of equitable diagnostic strategies and support further research into sex-specific care pathways for angina management. [Formula presented]

Publication Title

Journal of Nuclear Cardiology

Volume

50

Issue

Supplement

First Page

102323

Recommended Citation

Murillo-Garcia, D. R., Reggio, C., Razdan, N., Feldman, A., & Singh, A. (2025). Gender Disparities, Temporal Trends and Cardiovascular Outcomes in Patients with Angina Undergoing SPECT Stress Test. Journal of Nuclear Cardiology, 50 (Supplement), 102323. https://doi.org/https://doi.org/10.1016/j.nuclcard.2025.102323