Prognostic accuracy of myocardial perfusion imaging in octogenarians

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

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)1342-1349
Number of pages8
JournalJournal of Nuclear Cardiology
DOIs
Publication statusAccepted/In press - Nov 1 2017

Keywords

  • Coronary artery disease
  • Myocardial ischemia
  • Myocardial perfusion imaging
  • Octogenarians

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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