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CLINICAL RESEARCH

Tibolone Improves Myocardial Perfusion in Postmenopausal Women With Ischemic Heart Disease

An Open-Label Exploratory Pilot Study

Roxana Campisi, MD^_*,_*, Jorge Camilletti, MD^_*, Aníbal Mele, MD^_*, Juan Erriest, MD^_*, Pablo Pedroni, MD^_* and Ariel Guiglioni, MD

^_* Instituto de Cardiología La Plata, Buenos Aires, Argentina
Centro de Reproducción y Planificación Familiar, Buenos Aires, Argentina

Manuscript received March 19, 2005; revised manuscript received July 14, 2005, accepted September 10, 2005.

^_* Reprint requests and correspondence: Dr. Roxana Campisi, Division of Nuclear Medicine, Instituto de Cardiología La Plata, Calle 6 #212, La Plata (1900), Buenos Aires, Argentina (Email: roxanacampisi{at}aol.com).

OBJECTIVES: We sought to determine the effect of tibolone on myocardial perfusion in postmenopausal women with ischemic heart disease.

BACKGROUND: Tibolone is a steroid that relieves climacteric symptoms and prevents osteoporosis. Recent studies have suggested a cardioprotective effect of this compound. However, its role on myocardial perfusion remains uncertain.

METHODS: Single-photon emission computed tomography myocardial perfusion imaging was performed in 26 postmenopausal women. Patients were randomly assigned to tibolone for six months (treatment group) or to usual care (control group). All women underwent cardiac imaging at baseline and at six months.

RESULTS: Mean stress perfusion defect (summed stress score) was moderate and did not differ between the two groups (8 ± 3 vs. 9 ± 4; p = NS). Summed difference score also was similar for both groups (7 ± 3 vs. 8 ± 3; p = NS). The six-month study reveled that summed stress and summed difference scores significantly improved in the treatment group (to 3 ± 3 and to 2 ± 2; p < 0.001) whereas it remained unchanged for control patients (to 10 ± 4 and to 8 ± 2; p = NS).

CONCLUSIONS: In postmenopausal women with ischemic heart disease, six months of therapy with tibolone significantly improved stress myocardial perfusion and the "amount of ischemia."

Abbreviations and Acronyms   CAD = coronary artery disease   IHD = ischemic heart disease   NO = nitric oxide   RPP = rate-pressure product   SDS = summed difference score   SPECT = single-photon emission computed tomography   SRS = summed rest score   SSS = summed stress score