Burden of Myocardial Perfusion Abnormalities and Demographic Predictors of Coronary Artery Disease in Young South Asian Patients Undergoing SPECT-MPS

Abstract

Objectives: This study aimed to evaluate the demographic characteristics and myocardial perfusion abnormalities in young patients referred for myocardial perfusion scintigraphy (MPS) at a tertiary-care cardiac center. Methodology: In this retrospective observational study, we reviewed medical records of patients aged ≤50 years who underwent SPECT-MPS between September 2022 and September 2023 for suspected inducible ischemia or myocardial viability testing. Individuals with previously documented ischemic heart disease on coronary angiography were excluded. Perfusion defects were analyzed for extent, severity, and reversibility. Results: Among 184 patients, the mean age was 41.8 ± 7.1 years, with a predominance of males (63.0%). Chest pain (59.8%) and dyspnea (37.0%) were the most common presenting symptoms. Abnormal perfusion scans were observed in 46.7% of patients, with large defects being the most frequent (61.6%). Reversible perfusion abnormalities were present in 43% of abnormal scans, fixed defects in 44.2%, and partially reversible defects in 24.4%. Multivariable analysis showed age >35 years (OR 3.66), male sex (OR 1.97), and diabetes mellitus (OR 2.03) as significant predictors of abnormal MPS findings. Patients with abnormal scans demonstrated lower METs and reduced left ventricular ejection fraction. Conclusion: A considerable proportion of young South Asian patients undergoing MPS exhibited significant myocardial perfusion abnormalities, suggesting an early and substantial CAD burden in this demographic group. These findings highlight the need for earlier risk assessment, preventive strategies, and timely non-invasive cardiac evaluation to mitigate long-term cardiovascular consequences.