Prognostic value of dipyridamole echocardiography early after myocardial infarction in elderly patients

Angelo Camerieri, Eugenio Picano, Patrizia Landi, Claudio Michelassi, Alessandro Pingitore, Giovanni Minardi, Nicola Gandolfo, Giovanni Seveso, Francesco Chiarella, Leonardo Bolognese, Giacomo Chiarandà, Maria Grazia Sclavo, Mario Previtali, Franca Margaria, Ornella Magaia, Federico Bianchi, Salvatore Pirelli, Silva Severi, Mauro Raciti

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Abstract

Objectives. This study was conducted to assess the feasibility, safety and prognostic value of dipyridamole echocardiography in elderly patients recovering from an uncomplicated acute nyocardial infarction in a subset analysis performed on the patients entered in the subproject "residual ischemia" of the Echo Persantine Italian Cooperative Study (EPIC). Background. Coronary heart disease accounts for two thirds of all deaths in the age group >65 years, and >50% of all patients admitted to the hospital with acute myocardial infarction are >65 years old. The prognostic value of dipyridamole-induced left ventricular dysfunction was clearly established in patients evaluated early after acute infarction. Methods. In a subgroup analysis of the Echo Persantine Italian Cooperative Study (EPIC), we assessed the value of dipyridamole echocardiography in predicting cardiac events in 190 elderly (≥65 years) patients (age 68.4 ± 3.3 years, range 65 to 78; 147 men and 43 women) evaluated early (mean 10 days) after uncomplicated acute myocardial infarction and followed up for 14 ± 9.8 months. Results. There was no major side effect during dipyridamole echocardiography. A positive test result occurred in 85 patients (44.7%). During follow-up, there were 62 events (14 cardiac deaths, 7 nonfatal reinfarctions, 21 cases of class III or IV angina and 20 revascularization procedures). Of these 62 events, 44 occurred among 85 patients with positive dipyridamole echocardiography and 18 among 105 patients with negative dipyridamole echocardiography (52% vs. 17%, p <0.001). Spontaneous events (death, reinfarction, angina) occurred in 31 patints with positive and in 11 with negative dipyridamole echocardiography (36% vs. 10%, p <0.001). Hard events (myocardial infarction or death) occurred in 14 patients with positive and 7 with negative dipyridamole echocardiography (16% vs. 6%, p <0.05). Death occurred in 11 patients with positive and in 3 with negative dipyridamole echocardiography (13% vs. 3%, p <0.01). The positive predictive value of positive dipyridamole echocardiography and negative predictive value of negative dipyridamole echocardiography as related to the occurrence of all events in the follow-up period (death, reinfarction, angina, revascularization procedures) were 52% and 83%, respectively. The relative risk (that is, the relative risk of occurrence of future cardiac events in the group with positive dipyridamole echocardiography compared with that in those with negative dipyridamole echocardiography) was 3 for all events and 4.4 for death. Conclusions. Dipyridamole echocardiography was well tolerated by elderly patients and proved to be very effective in prognostic stratification early after uncomplicated acute myocardial infarction, even when only survival was considered.

Original languageEnglish
Pages (from-to)1809-1815
Number of pages7
JournalJournal of the American College of Cardiology
Volume22
Issue number7
DOIs
Publication statusPublished - 1993

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Dipyridamole
Echocardiography
Myocardial Infarction
Infarction
Left Ventricular Dysfunction

ASJC Scopus subject areas

  • Nursing(all)

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Prognostic value of dipyridamole echocardiography early after myocardial infarction in elderly patients. / Camerieri, Angelo; Picano, Eugenio; Landi, Patrizia; Michelassi, Claudio; Pingitore, Alessandro; Minardi, Giovanni; Gandolfo, Nicola; Seveso, Giovanni; Chiarella, Francesco; Bolognese, Leonardo; Chiarandà, Giacomo; Sclavo, Maria Grazia; Previtali, Mario; Margaria, Franca; Magaia, Ornella; Bianchi, Federico; Pirelli, Salvatore; Severi, Silva; Raciti, Mauro.

In: Journal of the American College of Cardiology, Vol. 22, No. 7, 1993, p. 1809-1815.

Research output: Contribution to journalArticle

Camerieri, A, Picano, E, Landi, P, Michelassi, C, Pingitore, A, Minardi, G, Gandolfo, N, Seveso, G, Chiarella, F, Bolognese, L, Chiarandà, G, Sclavo, MG, Previtali, M, Margaria, F, Magaia, O, Bianchi, F, Pirelli, S, Severi, S & Raciti, M 1993, 'Prognostic value of dipyridamole echocardiography early after myocardial infarction in elderly patients', Journal of the American College of Cardiology, vol. 22, no. 7, pp. 1809-1815. https://doi.org/10.1016/0735-1097(93)90762-P
Camerieri, Angelo ; Picano, Eugenio ; Landi, Patrizia ; Michelassi, Claudio ; Pingitore, Alessandro ; Minardi, Giovanni ; Gandolfo, Nicola ; Seveso, Giovanni ; Chiarella, Francesco ; Bolognese, Leonardo ; Chiarandà, Giacomo ; Sclavo, Maria Grazia ; Previtali, Mario ; Margaria, Franca ; Magaia, Ornella ; Bianchi, Federico ; Pirelli, Salvatore ; Severi, Silva ; Raciti, Mauro. / Prognostic value of dipyridamole echocardiography early after myocardial infarction in elderly patients. In: Journal of the American College of Cardiology. 1993 ; Vol. 22, No. 7. pp. 1809-1815.
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title = "Prognostic value of dipyridamole echocardiography early after myocardial infarction in elderly patients",
abstract = "Objectives. This study was conducted to assess the feasibility, safety and prognostic value of dipyridamole echocardiography in elderly patients recovering from an uncomplicated acute nyocardial infarction in a subset analysis performed on the patients entered in the subproject {"}residual ischemia{"} of the Echo Persantine Italian Cooperative Study (EPIC). Background. Coronary heart disease accounts for two thirds of all deaths in the age group >65 years, and >50{\%} of all patients admitted to the hospital with acute myocardial infarction are >65 years old. The prognostic value of dipyridamole-induced left ventricular dysfunction was clearly established in patients evaluated early after acute infarction. Methods. In a subgroup analysis of the Echo Persantine Italian Cooperative Study (EPIC), we assessed the value of dipyridamole echocardiography in predicting cardiac events in 190 elderly (≥65 years) patients (age 68.4 ± 3.3 years, range 65 to 78; 147 men and 43 women) evaluated early (mean 10 days) after uncomplicated acute myocardial infarction and followed up for 14 ± 9.8 months. Results. There was no major side effect during dipyridamole echocardiography. A positive test result occurred in 85 patients (44.7{\%}). During follow-up, there were 62 events (14 cardiac deaths, 7 nonfatal reinfarctions, 21 cases of class III or IV angina and 20 revascularization procedures). Of these 62 events, 44 occurred among 85 patients with positive dipyridamole echocardiography and 18 among 105 patients with negative dipyridamole echocardiography (52{\%} vs. 17{\%}, p <0.001). Spontaneous events (death, reinfarction, angina) occurred in 31 patints with positive and in 11 with negative dipyridamole echocardiography (36{\%} vs. 10{\%}, p <0.001). Hard events (myocardial infarction or death) occurred in 14 patients with positive and 7 with negative dipyridamole echocardiography (16{\%} vs. 6{\%}, p <0.05). Death occurred in 11 patients with positive and in 3 with negative dipyridamole echocardiography (13{\%} vs. 3{\%}, p <0.01). The positive predictive value of positive dipyridamole echocardiography and negative predictive value of negative dipyridamole echocardiography as related to the occurrence of all events in the follow-up period (death, reinfarction, angina, revascularization procedures) were 52{\%} and 83{\%}, respectively. The relative risk (that is, the relative risk of occurrence of future cardiac events in the group with positive dipyridamole echocardiography compared with that in those with negative dipyridamole echocardiography) was 3 for all events and 4.4 for death. Conclusions. Dipyridamole echocardiography was well tolerated by elderly patients and proved to be very effective in prognostic stratification early after uncomplicated acute myocardial infarction, even when only survival was considered.",
author = "Angelo Camerieri and Eugenio Picano and Patrizia Landi and Claudio Michelassi and Alessandro Pingitore and Giovanni Minardi and Nicola Gandolfo and Giovanni Seveso and Francesco Chiarella and Leonardo Bolognese and Giacomo Chiarand{\`a} and Sclavo, {Maria Grazia} and Mario Previtali and Franca Margaria and Ornella Magaia and Federico Bianchi and Salvatore Pirelli and Silva Severi and Mauro Raciti",
year = "1993",
doi = "10.1016/0735-1097(93)90762-P",
language = "English",
volume = "22",
pages = "1809--1815",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
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TY - JOUR

T1 - Prognostic value of dipyridamole echocardiography early after myocardial infarction in elderly patients

AU - Camerieri, Angelo

AU - Picano, Eugenio

AU - Landi, Patrizia

AU - Michelassi, Claudio

AU - Pingitore, Alessandro

AU - Minardi, Giovanni

AU - Gandolfo, Nicola

AU - Seveso, Giovanni

AU - Chiarella, Francesco

AU - Bolognese, Leonardo

AU - Chiarandà, Giacomo

AU - Sclavo, Maria Grazia

AU - Previtali, Mario

AU - Margaria, Franca

AU - Magaia, Ornella

AU - Bianchi, Federico

AU - Pirelli, Salvatore

AU - Severi, Silva

AU - Raciti, Mauro

PY - 1993

Y1 - 1993

N2 - Objectives. This study was conducted to assess the feasibility, safety and prognostic value of dipyridamole echocardiography in elderly patients recovering from an uncomplicated acute nyocardial infarction in a subset analysis performed on the patients entered in the subproject "residual ischemia" of the Echo Persantine Italian Cooperative Study (EPIC). Background. Coronary heart disease accounts for two thirds of all deaths in the age group >65 years, and >50% of all patients admitted to the hospital with acute myocardial infarction are >65 years old. The prognostic value of dipyridamole-induced left ventricular dysfunction was clearly established in patients evaluated early after acute infarction. Methods. In a subgroup analysis of the Echo Persantine Italian Cooperative Study (EPIC), we assessed the value of dipyridamole echocardiography in predicting cardiac events in 190 elderly (≥65 years) patients (age 68.4 ± 3.3 years, range 65 to 78; 147 men and 43 women) evaluated early (mean 10 days) after uncomplicated acute myocardial infarction and followed up for 14 ± 9.8 months. Results. There was no major side effect during dipyridamole echocardiography. A positive test result occurred in 85 patients (44.7%). During follow-up, there were 62 events (14 cardiac deaths, 7 nonfatal reinfarctions, 21 cases of class III or IV angina and 20 revascularization procedures). Of these 62 events, 44 occurred among 85 patients with positive dipyridamole echocardiography and 18 among 105 patients with negative dipyridamole echocardiography (52% vs. 17%, p <0.001). Spontaneous events (death, reinfarction, angina) occurred in 31 patints with positive and in 11 with negative dipyridamole echocardiography (36% vs. 10%, p <0.001). Hard events (myocardial infarction or death) occurred in 14 patients with positive and 7 with negative dipyridamole echocardiography (16% vs. 6%, p <0.05). Death occurred in 11 patients with positive and in 3 with negative dipyridamole echocardiography (13% vs. 3%, p <0.01). The positive predictive value of positive dipyridamole echocardiography and negative predictive value of negative dipyridamole echocardiography as related to the occurrence of all events in the follow-up period (death, reinfarction, angina, revascularization procedures) were 52% and 83%, respectively. The relative risk (that is, the relative risk of occurrence of future cardiac events in the group with positive dipyridamole echocardiography compared with that in those with negative dipyridamole echocardiography) was 3 for all events and 4.4 for death. Conclusions. Dipyridamole echocardiography was well tolerated by elderly patients and proved to be very effective in prognostic stratification early after uncomplicated acute myocardial infarction, even when only survival was considered.

AB - Objectives. This study was conducted to assess the feasibility, safety and prognostic value of dipyridamole echocardiography in elderly patients recovering from an uncomplicated acute nyocardial infarction in a subset analysis performed on the patients entered in the subproject "residual ischemia" of the Echo Persantine Italian Cooperative Study (EPIC). Background. Coronary heart disease accounts for two thirds of all deaths in the age group >65 years, and >50% of all patients admitted to the hospital with acute myocardial infarction are >65 years old. The prognostic value of dipyridamole-induced left ventricular dysfunction was clearly established in patients evaluated early after acute infarction. Methods. In a subgroup analysis of the Echo Persantine Italian Cooperative Study (EPIC), we assessed the value of dipyridamole echocardiography in predicting cardiac events in 190 elderly (≥65 years) patients (age 68.4 ± 3.3 years, range 65 to 78; 147 men and 43 women) evaluated early (mean 10 days) after uncomplicated acute myocardial infarction and followed up for 14 ± 9.8 months. Results. There was no major side effect during dipyridamole echocardiography. A positive test result occurred in 85 patients (44.7%). During follow-up, there were 62 events (14 cardiac deaths, 7 nonfatal reinfarctions, 21 cases of class III or IV angina and 20 revascularization procedures). Of these 62 events, 44 occurred among 85 patients with positive dipyridamole echocardiography and 18 among 105 patients with negative dipyridamole echocardiography (52% vs. 17%, p <0.001). Spontaneous events (death, reinfarction, angina) occurred in 31 patints with positive and in 11 with negative dipyridamole echocardiography (36% vs. 10%, p <0.001). Hard events (myocardial infarction or death) occurred in 14 patients with positive and 7 with negative dipyridamole echocardiography (16% vs. 6%, p <0.05). Death occurred in 11 patients with positive and in 3 with negative dipyridamole echocardiography (13% vs. 3%, p <0.01). The positive predictive value of positive dipyridamole echocardiography and negative predictive value of negative dipyridamole echocardiography as related to the occurrence of all events in the follow-up period (death, reinfarction, angina, revascularization procedures) were 52% and 83%, respectively. The relative risk (that is, the relative risk of occurrence of future cardiac events in the group with positive dipyridamole echocardiography compared with that in those with negative dipyridamole echocardiography) was 3 for all events and 4.4 for death. Conclusions. Dipyridamole echocardiography was well tolerated by elderly patients and proved to be very effective in prognostic stratification early after uncomplicated acute myocardial infarction, even when only survival was considered.

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