Women with Breast Implants Have Higher Adjusted Abnormal Cardiac Testing and Coronary Angiography but Lower Coronary Intervention.

Abstract

Background: Breast implants interfere with myocardial perfusion imaging (single photon emission computed tomography) and echocardiographic windows, leading to increased false-positive results. To validate this concept, we hypothesized that patients with breast implants should have higher positive cardiac testing and coronary angiogram with lower percutaneous coronary intervention (PCI) rates compared with women without a breast implant.

Methods: Using International Classification of Diseases, 10th Revision codes for breast implants, abnormal results of cardiac functional study, coronary angiogram, and PCIs, we evaluated any association between these parameters in adult women with breast implants utilizing the National Inpatient Sample database.

Results: A total of 45,015 women had abnormal cardiac functional studies. A total of 1,871,335 women ages 18 years or older underwent coronary angiography. From those, 865,020 underwent PCI. Women with breast implants with abnormal cardiac functional tests were 10 years younger (55.06 vs 65.06 years, P < .001). Furthermore, the breast implant cohort had a higher adjusted abnormal cardiac functional study (odds ratio [OR] 1.78; 95% confidence interval [CI], 1.11-2.26; P = .02). Adult women with breast implants also had a significantly higher rate of adjusted coronary angiography (OR 1.3; 95% CI, 1.17-1.44; P < .001) but a lower rate of PCI (35.7% vs 46.2%, P < .001, unadjusted OR 0.65; 95% CI, 0.54-0.78; adjusted OR 0.79; 95% CI, 0.65-0.98; P = .01).

Conclusions: Women with breast implants had higher adjusted positive cardiac functional studies, and a higher adjusted rate of coronary angiography but lower rates of PCI, consistent with our hypothesis that breast implant interference can increase abnormal cardiac testing, leading to an increase in the utilization of coronary angiography.