Tibolone improves myocardial perfusion in postmenopausal women with ischemic heart disease: an open-label exploratory pilot study.

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 revealed 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."