title: Risk stratification for large artery or chronic coronary artery disease-related ischemic stroke in octogenarians undergoing exercise stress myocardial perfusion imaging: A cohort study.
abstract: To test, if in octogenarians, treadmill exercise with myocardial perfusion imaging (exercise-MPI) can risk stratify for large artery or chronic CAD-related ischemic stroke (LACCIS).
  
  
  
  Exercise-MPI-related data of 237 octogenarians (55% prior MI or revascularization) without previous stroke were registered and prospective follow-up was performed to document LACCIS. LACCIS was defined as acute onset of neurological symptoms with CT/MRI findings of non-lacunar-type infarcts in the absence of atrial fibrillation or intracardiac embolic sources.
  
  
  
  After 7.3 years, 10 LACCIS were documented. SSS [HR 1.08 (1.02-1.13 95% CIs), SDS [HR 1.1 (1.04-1.16 95% CIs)], and non-sustained VT or transient AV block during exercise [HR 3.9 (1.7-9.0 95% CIs)] were predictors of LACCIS (P < .01 for all). A SSS threshold of 16 had 81% specificity for identification of future LACCIS and risk groups formed according to this cut-off had significantly different LACCIS-free survival (P = .015).
  
  
  
  Exercise-MPI in octogenarians can provide risk stratification markers for LACCIS.
authors.affiliation: Nuclear Medicine Department, Onassis Cardiac Surgery Center, Kallithea, Greece. tkatsikis@gmail.com.|Cardiology Department, 401 General Military Hospital of Athens, Athens, Greece. tkatsikis@gmail.com.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Katsikis
authors.affiliation: Nuclear Medicine Department, Onassis Cardiac Surgery Center, Kallithea, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Theodorakos
authors.affiliation: Cardiology Department, Attikon University Hospital, Athens, Greece.|Cardiology Department, 401 General Military Hospital of Athens, Athens, Greece.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Drosatos
authors.affiliation: Cardiology Department, 401 General Military Hospital of Athens, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Konstantinou
authors.affiliation: Nuclear Medicine Department, Onassis Cardiac Surgery Center, Kallithea, Greece.|Cardiology Department, Athens Naval Hospital, Athens, Greece.
authors.forename: Spyridon
authors.initials: S
authors.lastname: Papaioannou
authors.affiliation: Nuclear Medicine Department, Onassis Cardiac Surgery Center, Kallithea, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Koutelou
mesh_terms: D000369:Aged, 80 and over; D015984:Causality; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality*; D005080:Exercise Test / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods / Q000706:statistics & numerical data*; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D020521:Stroke / Q000000981:diagnostic imaging* / Q000401:mortality*; D015996:Survival Rate
keywords: Octogenarians; exercise stress test; myocardial perfusion imaging; stroke