Prognostic role of myocardial single photon emission computed tomography in the elderly.
The increase in average life expectancy will move the burden of coronary artery disease (CAD) to older patients. Myocardial perfusion imaging by single photon emission computed tomography (SPECT) has been extensively validated for diagnosis and prognostic evaluation in large population series. Yet, its use is usually limited in elderly patients in whom, despite increased absolute cardiovascular risk, diagnostic and therapeutic work-up is often underperformed. American College of Cardiology/American Heart Association guidelines recommend exercise ECG testing as the initial noninvasive method for assessment of CAD in patients with a normal or near-normal resting ECG, regardless of age. However, a considerable proportion of elderly patients is unable to reach an adequate workload during the exercise test and the majority of those undergoing for standard exercise treadmill score are classified as intermediate risk. In elderly patients, SPECT imaging may provide valuable diagnostic and prognostic information for clinical management. In particular, normal or near normal SPECT identifies elderly patients at low risk of major adverse cardiac events at the short-term follow-up.
Perrone-Filardi
Pasquale
P
Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University, Via S. Pansini 5, Naples, 80131, Italy. fpperron@unina.it
Costanzo
Pierluigi
P
Dellegrottaglie
Santo
S
Gargiulo
Paola
P
Ruggiero
Donatella
D
Savarese
Gianluigi
G
Parente
Antonio
A
D'Amore
Carmen
C
Cuocolo
Alberto
A
Chiariello
Massimo
M
D000368:Aged; D000369:Aged, 80 and over; D002309:Cardiology / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D015203:Reproducibility of Results; D012306:Risk; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*