We read the article by Rivero et al1 with great interest. The authors calculated gender-specific normal values for transient ischemic dilation (TID) with and without attenuation correction. The 75 study patients (33 women and 42 men) had a low pre-SPECT test likelihood of coronary artery disease (CAD) (<5). Of those 75 patients, 11 had abnormal perfusion scans compared with a reference database, indicating a post-SPECT test likelihood of CAD surely much higher than 5. Hence, we believe that the data from those 11 patients cannot be used to calculate normal TID values. Since the authors did not show the gender distribution for these 11 patients, the question arises as to whether the group contained more women than men, which could eventually explain the gender-specific differences in the normal TID values.
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