Stress echocardiography for predicting cardiac events in octogenarians: is myocardial perfusion scintigraphy necessary anymore?
The use of stress echocardiography (SE) in an elderly population was retrospectively evaluated and compared with myocardial perfusion scintigraphy (MPS) in a similar group. Patients > or = 80 years of age were evaluated by treadmill or pharmacologic SE (group 1; n = 65) to determine its predictive value for cardiac events. A second group had MPS (group 2; n = 68). We identified 11 patients in group 1 and 25 in group 2 who had a cardiac event, with no statistical significance between the positive predictive value of SE and MPS (55% vs 49%) and the negative predictive value of SE and MPS (89% vs 73%). The actuarial event-free survival was better for patients with negative SE than for patients with positive SE or negative or positive MPS. This study suggests that SE is comparable to MPS as a prognosticator of cardiac events in octogenarians. The retrospective design and the small population studied are major limitations. A larger, prospective trial should be launched to analyze this group and compare various stress tests.
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Department of Cardiology, Cleveland Clinic Florida, Fort Lauderdale 33309, USA.
Lara
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Bournigal
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D000206:Actuarial Analysis; D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004176:Dipyridamole; D004452:Echocardiography / Q000379:methods; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
D004176:Dipyridamole