Prognostic Accuracy of Myocardial Perfusion Imaging in Octogenarians

Overview

Journal J Nucl Cardiol

Specialty Cardiology & Vascular Diseases

Date 2017 Nov 3

PMID 29094297

Citations 8

Authors

Francesco Nudi

Giuseppe Biondi-Zoccai

Orazio Schillaci

Natale Di Belardino

Francesco Versaci

Alessandro Nudi

Annamaria Pinto

Giandomenico Neri

Enrica Procaccini

Giacomo Frati

Ami E Iskandrian

Affiliations

Soon will be listed here.

Abstract

Background: Myocardial perfusion imaging (MPI) has an established role in the work-up of coronary artery disease (CAD), but its comparative accuracy is debated in elderly patients. We examined a large administrative database to appraise the performance of MPI in octogenarians.

Methods: Our institutional database was queried for patients undergoing MPI without recent coronary revascularization or myocardial infarction (MI). We compared baseline, procedural, diagnostic, and prognostic features in patients aged < 80 vs ≥ 80 years with bivariate and propensity-adjusted analyses.

Results: From 13,254 patients, 12,737 (96.1%) were < 80 years old and 517 (3.9%) ≥ 80 years. Octogenarians were less likely to undergo exercise testing, had more severe and extensive myocardial ischemia (all P < 0.001), whereas CAD was more prevalent and diffuse in them (P = 0.012), and major adverse cardiac events more common during follow-up (P = 0.009). Diagnostic accuracy of MPI was similar or higher in octogenarians than in younger patients (e.g., sensitivity for three-vessel disease 92% in octogenarians vs 91% in younger patients), as was prognostic accuracy. Using propensity-matched analyses, MPI again yielded satisfactory prognostic accuracy in octogenarians.

Conclusions: Use of MPI in octogenarians is associated with similar or better prognostic accuracy than in younger subjects.

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