title: Pertinence of myocardial perfusion imaging in octogenarians.
abstract: OBJECTIVE
  Coronary artery disease (CAD) is the leading cause of morbidity and mortality in the elderly population. Atypical presentation, reduced activity levels, and comorbidity often confound the diagnosis. We studied the use of stress myocardial perfusion imaging (MPI) in octogenarians.
  
  
  METHODS
  We retrospectively reviewed the medical records of all patients with both MPI and coronary angiogram within 6 months from 1998 to 2008. Sixty veterans under the age of 60 years who underwent both cardiac procedures served as controls.
  
  
  RESULTS
  We evaluated 53 patients, predominantly men, with mean age of 85 +/- 2.5 yrs. Chest pain (68%) was the most common reason for requesting the stress test. Risk factors included diabetes 44%, hypertension 93%, smoking 48%, hyperlipidemia 93%, and peripheral vascular disease 40%. All patients had an abnormal myocardial perfusion scan. Reversible defects were present in 91% with the following distribution: mild 26%, moderate 39%, severe 15% and multiple defects 11%. Fixed defects were present in 44% of the patients. Analysis of both studies in the 53 patients revealed complete (43), partial (7) and no correlation (3) between the MPI defects and culprit lesions identified on the coronary angiogram. Positive predictive value and accuracy of the myocardial perfusion scan in detection of the disease was 98%. Follow up ranged from 1 to 10 years during which 19 patients died, and 7 deaths were cardiac.
  
  
  CONCLUSIONS
  Myocardial perfusion imaging in octogenarians is as accurate in diagnosing CAD as it is in younger people.
authors.affiliation: Harry S Truman VA Medical Center, Columbia, Missouri, USA.
authors.forename: Manavjot
authors.initials: M
authors.lastname: Sidhu
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Bhalla
authors.forename: Anand
authors.initials: A
authors.lastname: Chockalingam
authors.forename: Thomas
authors.initials: T
authors.lastname: Dresser
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D055414:Myocardial Perfusion Imaging; D011237:Predictive Value of Tests; D013318:Stroke Volume