Nudi F, Biondi-Zoccai G, Schillaci O, di Belardino N, Versaci F, Nudi A, Pinto A, Neri G, Procaccini E, Frati G, Iskandrian AE. Prognostic accuracy of myocardial perfusion imaging in octogenarians.
J Nucl Cardiol 2018;
25:1342-1349. [PMID:
29094297 DOI:
10.1007/s12350-017-1102-x]
[Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/02/2017] [Indexed: 02/05/2023]
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.
Collapse