title: Risk stratification by accelerated high-dose dipyridamole stress echocardiography in patients over 70 years of age.
abstract: BACKGROUND
  The non-invasive prognostic assessment of coronary artery disease in patients over 70 years old is an important goal in daily clinical practice.
  
  
  OBJECTIVE
  To retrospectively assess the feasibility, the positive and negative predictive values and the accuracy of accelerated high-dose dipyridamole stress echocardiography in patients over 70 years old.
  
  
  METHODS
  Three hundred seventy nine patients (226 women; mean age of 75.9±4.6 years) underwent dipyridamole stress echocardiography.
  
  
  RESULTS
  Follow-up data were available for 313 patients (mean follow-up duration 21±15.7 months). Overall feasibility was 97%. Positive predictive values were 30% and 40% for 6 and 12 months of follow-up, respectively. Negative predictive values were 97.7% and 96.7% for 6 and 12 months of follow-up, respectively. Accuracy values were 95.5% and 94.9% for 6 and 12 months of follow-up, respectively. Among the clinical variables, dyslipidemia (OR 5.3; CI 95% 1.3-20.9; p=0.016), coronary artery disease (OR 4.2; CI 95% 1.3-13.3; p=0.014) and a positive stress echo response (OR 9.0; CI 95% 1.7-49.1; p=0.011) were independently associated with the occurrence of a cardiovascular event. A Cox regression model showed that male gender and a positive stress echo response significantly predicted death.
  
  
  CONCLUSIONS
  Risk stratification with accelerated high-dose dipyridamole stress echocardiography is feasible in patients over 70 years old. A positive stress echo response, the presence of coronary artery disease, and dyslipidemia positively predicted the occurrence of cardiovascular events. Male gender and a positive stress echo response significantly predicted death.
authors.affiliation: Center of Health and Biological Sciences, Pontificia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Prado Velho, CEP: 80215-901 Curitiba, Paraná, Brazil. Electronic address: lizandreabaroncini@hotmail.com.
authors.forename: Liz Andréa Villela
authors.initials: LAV
authors.lastname: Baroncini
authors.affiliation: Center of Health and Biological Sciences, Pontificia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Prado Velho, CEP: 80215-901 Curitiba, Paraná, Brazil.
authors.forename: Leonardo Brandão
authors.initials: LB
authors.lastname: Précoma
authors.affiliation: Medical School, Universidade Evangélica, Curitiba, Paraná, Brazil.
authors.forename: Cintia Doná
authors.initials: CD
authors.lastname: Busato
authors.affiliation: Medical School, Universidade Evangélica, Curitiba, Paraná, Brazil.
authors.forename: Mariel
authors.initials: M
authors.lastname: Monclaro
authors.affiliation: Center of Health and Biological Sciences, Pontificia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Prado Velho, CEP: 80215-901 Curitiba, Paraná, Brazil.
authors.forename: Daniel Précoma
authors.initials: DP
authors.lastname: Neto
authors.affiliation: Department of Internal Medicine, Medical School, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Alessi
authors.affiliation: Center of Health and Biological Sciences, Pontificia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Prado Velho, CEP: 80215-901 Curitiba, Paraná, Brazil.
authors.forename: Dalton Bertolim
authors.initials: DB
authors.lastname: Précoma
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D004176:Dipyridamole / Q000008:administration & dosage* / Q000009:adverse effects; D050171:Dyslipidemias / Q000000981:diagnostic imaging* / Q000453:epidemiology; D025401:Echocardiography, Stress / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D014665:Vasodilator Agents; D004176:Dipyridamole