title: Adenosine triphosphate stress myocardial perfusion imaging for risk stratification of patients aged 70 years and older with suspected coronary artery disease.
abstract: We investigated the cardiac risk stratification value of adenosine triphosphate stress myocardial perfusion imaging (ATP-MPI) in patients aged 70 years and older with suspected coronary artery disease (CAD).
  
  
  
  We identified a series of 415 consecutive patients aged 70 years and older with suspected CAD, who had undergone ATP-MPI with99mTc-MIBI. The presence of a fixed and/or reversible perfusion defect was considered as an abnormal MPI. Follow-up was available in 399 patients (96.1%) over 3.45 ± 1.71 years after excluding 16 patients who underwent early coronary revascularization <60 days after MPI. The major adverse cardiac events (MACE), including cardiac death, nonfatal infarction, and late coronary revascularization, were recorded.
  
  
  
  One hundred twenty-five (31.3%) patients had abnormal MPI and the remaining had normal MPI. A multivariable analysis using Cox regression demonstrated that abnormal MPI was independently associated with MACE (hazard ratio 19.50 and 95% confidence interval 5.91-64.31, P value .000). The patients with SSS > 8 had significantly higher cumulative MACE rate than patients with SSS ≤ 8 had (37.8% vs 5.2%, respectively, P < .001). The Kaplan-Meier cumulative MACE-free survival in patients with abnormal MPI (57.0%) was significantly lower than that in patients with normal MPI (89.6%), P < .0001. Among patients with SSS > 8, the Kaplan-Meier cumulative MACE-free survival were 36.9% in patients ≥80 years old and 49.5% in patients 70-79 years old, respectively, P < .05. However, among patients with SSS ≤ 8, there was no difference between the Kaplan-Meier cumulative MACE-free survivals of these two age groups.
  
  
  
  ATP-MPI data are useful for the prediction of major adverse cardiac events in patients aged 70 years and older with suspected CAD.
authors.affiliation: Department of Nuclear Medicine, Beijing Hospital, Dahua Road, Dongdan, Beijing, 100730, People's Republic of China. yao.zhiming@163.com.
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Yao
authors.affiliation: Department of Nuclear Medicine, Beijing Hospital, Dahua Road, Dongdan, Beijing, 100730, People's Republic of China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhu
authors.affiliation: Department of Nuclear Medicine, Beijing Hospital, Dahua Road, Dongdan, Beijing, 100730, People's Republic of China.
authors.forename: Wenchan
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Nuclear Medicine, Beijing Hospital, Dahua Road, Dongdan, Beijing, 100730, People's Republic of China.
authors.forename: Congxia
authors.initials: C
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Beijing Hospital, Beijing, People's Republic of China.
authors.forename: Hua
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Nuclear Medicine, Beijing Hospital, Dahua Road, Dongdan, Beijing, 100730, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Shi
authors.affiliation: Department of Nuclear Medicine, Beijing Hospital, Dahua Road, Dongdan, Beijing, 100730, People's Republic of China.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Zhang
mesh_terms: D000255:Adenosine Triphosphate; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000601:surgery; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods* / Q000706:statistics & numerical data; D062645:Percutaneous Coronary Intervention / Q000401:mortality*; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods* / Q000706:statistics & numerical data; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D000255:Adenosine Triphosphate
keywords: ATP; Elderly; coronary artery disease; prognosis; single-photon emission computed tomography myocardial perfusion imaging