[Prognostic value of adenosine triphosphate myocardial perfusion tomography in octogenarians.].
OBJECTIVE
To evaluate the prognostic value of (99m)Tc-MIBI myocardial perfusion single-photon emission computed tomography (MPS) with adenosine triphosphate in patients aged 80 years or older.


METHODS
A total of 265 patients [mean age (84.2 +/- 3.6) years old] who underwent adenosine triphosphate and rest (99m)Tc-MIBI myocardial SPECT imaging were followed-up for (36.7 +/- 22.8) months.


RESULTS
During the period of follow-up, 57 patients (20.4%) suffered from cardiac events, including 20 major events: 5 cardiac death and 15 acute non-fatal myocardial infarction, 14 unstable angina pectoris, 7 heart failure and 16 cases undergoing PCI. The cardiac event rate in patients with fixed or mixed perfusion defects (n = 54) was 50%, which was significantly higher than that in patients with reversible perfusion defects (n = 67, 31.3%, P < 0.05) and normal perfusion imaging (n = 144, 6.2%, P < 0.01). The major cardiac event rate in patients with fixed or mixed perfusion defects was 27.8%, which was significantly higher than that in those with reversible perfusion defects (6.0%, P < 0.05) and normal perfusion imaging (0.7%, P < 0.01). Cox multivariate analysis revealed that an abnormal MPS was the most important independent predictor of major or total cardiac events.


CONCLUSIONS
(99m)Tc-MIBI MPS with ATP is demonstrated to be a powerful tool for the prognostic evaluation in octogenarian population. Octogenarians with a normal MPS have a low risk of major or total cardiac events, but when an abnormal MPS is present, the risk is significantly higher, being highest in patients with fixed or mixed perfusion defects.
Wang
Hua
H
Departments of Nuclear Medicine and Cardiology, Beijing Hospital, Beijing 100730, China. Email: yao.zhiming@163.com.
Zeng
Xue-Zhai
XZ
Yang
Jie-Fu
JF
Liu
De-Ping
DP
Yu
Zhi-Guo
ZG
Li
Wei
W
Yao
Zhi-Ming
ZM
D000255:Adenosine Triphosphate; D006801:Humans; D011379:Prognosis; D012307:Risk Factors; D017256:Technetium Tc 99m Sestamibi; D014054:Tomography; D015899:Tomography, Emission-Computed, Single-Photon
D000255:Adenosine Triphosphate; D017256:Technetium Tc 99m Sestamibi