[Exercise stress test: prognostic value for elderly patients with stable coronary atherosclerosis].
OBJECTIVE
To study the prognostic value of exercise stress test variables in elderly patients with coronary atherosclerosis and exercise-induced ischemia.


METHODS
Sixty-four elderly patients (61 men, 73 +/- 5 years old) with coronary atherosclerosis, verified by cardiac catheterization, that were clinically stable, had a left ventricle ejection fraction greater than or equal to 0.40 and developed myocardial ischemia during the exercise stress test were studied. The patients were evaluated every six months for cardiac events (death, myocardial infarction, unstable angina, angioplasty and myocardial revascularization).


RESULTS
After a mean follow-up period of 48 months, 23 (36%) patients suffered cardiac events. There was no clinical or angiographical differences among the patients that suffered cardiac events and those that did not. Using multivariate analysis, the presence of chest pain during the exercise stress test (relative risk 2.668, p = 0.031) and the heart rate at the onset of ischemia (relative risk 0.966, p = 0.009) were associated with cardiac events.


CONCLUSIONS
In this elderly population, the presence of chest pain during the exercise stress test and the heart rate at the onset of ischemia were associated with cardiac events. These variables could be useful for risk evaluation in patients with stable coronary atherosclerosis.
Ochiai
Marcelo Eidi
ME
Instituto do Coração, Hospital das Clínicas, FMUSP, São Paulo, SP. mochiai@osite.com.br
Gebara
Otávio C E
OC
Serro-Azul
João Batista
JB
Pinto
Lígia B
LB
Nussbacher
Amit
A
Pierri
Humberto
H
Wajngarten
Mauricio
M
D000368:Aged; D000789:Angina, Unstable / Q000175:diagnosis / Q000503:physiopathology; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000503:physiopathology*; D005080:Exercise Test; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D009204:Myocardial Revascularization; D011379:Prognosis; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000503:physiopathology