TY - JOUR
T1 - Prognostic accuracy of myocardial perfusion imaging in octogenarians
AU - Nudi, Francesco
AU - Biondi-Zoccai, Giuseppe
AU - Schillaci, Orazio
AU - Di Belardino, Natale
AU - Versaci, Francesco
AU - Nudi, Alessandro
AU - Pinto, Annamaria
AU - Neri, Giandomenico
AU - Procaccini, Enrica
AU - Frati, Giacomo
AU - Iskandrian, Ami E.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - 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.
AB - 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.
KW - Coronary artery disease
KW - Myocardial ischemia
KW - Myocardial perfusion imaging
KW - Octogenarians
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U2 - 10.1007/s12350-017-1102-x
DO - 10.1007/s12350-017-1102-x
M3 - Article
AN - SCOPUS:85032819440
SP - 1342
EP - 1349
JO - Journal of Nuclear Cardiology
JF - Journal of Nuclear Cardiology
SN - 1071-3581
ER -