The Effect of Long Term Smoking as an Independent Coronary Risk Factor on Myocardial Perfusion Detected by Thallium 201 or Tc99m Sestamibi Spect Study

Abstract

Objective: The aim of this work was to assess the effect of smoking as an independent coronary risk factor on Myocardial Perfusion detected by Thallium 201 or Tc99m Sesta MIBI SPECT study.Methods: This study included 200 patients, 100 who are smokers only (group A) without any cardiac risks and the other 100 (group B) were nonsmokers, but with single cardiac risk factor as hypertension or diabetes. Each was subjected to Dipyridamole (smokers 53, 47) or exercise (nonsmokers 51, 49) Thallium-201 or Tc99m SestaMIBI SPECT protocol.Results: Comparing smokers versus nonsmokers who have another one risk factor, smokers had : Lower age with ischemic heart disease 55 years versus 60 years; Higher heart rate during peak stress; higher blood pressure during peak stress; More incidence of chest pain during stress test; had the same degree of ischemic perfusion defect, but higher incidence of persistent LV dilatation (43% versus 28%), higher incidence of severe perfusion defects (68% versus 53%) and statistically significant higher incidence of scar tissue (52% versus 30%).Conclusion: Smoking is an independent risk factor equal to hypertension and diabetes but smokers has higher incidence of severe perfusion defects and scar.