UNLABELLED: Information on the prognostic value of noninvasive stress imaging techniques in the elderly is relatively scarce. This study assessed the prognostic value of dobutamine stress (99m)Tc-tetrofosmin SPECT for the prediction of mortality and cardiac events in elderly patients. METHODS: Clinical information and SPECT results were analyzed for 272 consecutive patients > or = 65 y old (mean age, 71 +/- 5 y; range, 65-87 y) with limited exercise capacity. Follow-up was complete in 270 patients (99.3%); 23 underwent revascularization within 60 d of the scintigraphy and were excluded. Abnormal findings were defined as the presence of a fixed or reversible perfusion defect. A summed stress score was obtained to estimate the extent and severity of perfusion defects. The incremental prognostic value of SPECT over clinical data was evaluated according to 3 multivariate models, which included any SPECT abnormality, the presence of a fixed or reversible defect, and the summed stress score. RESULTS: During the follow-up (3.3 +/- 1.4 y), 59 patients died (29 cardiac deaths), 16 had a nonfatal infarction, and 49 underwent late revascularization. Abnormal scan findings were present for 140 patients (57%). The annual event rates for total mortality, cardiac death, and cardiac death or nonfatal infarction were, respectively, 3.2%, 0.2%, and 0.7% when scan findings were normal and, respectively, 9.5%, 4.3%, and 8% when scan findings were abnormal (all P < 0.0001). Multivariate analysis showed that abnormal scan findings, the presence of a fixed or reversible defect, and the summed stress score provided incremental prognostic information over clinical data. The presence of abnormal scan findings was independently associated with an increased risk for total mortality, cardiac death, and cardiac death or nonfatal infarction (respectively, hazard ratio 3.4 [95% CI, 1.8-6.5], 12.1 [95% CI, 2.9-51.5], and 9.0 [95% CI, 2.8-29.6]). CONCLUSION: Dobutamine stress (99m)Tc-tetrofosmin SPECT provides incremental prognostic information for the prediction of total mortality and cardiac events in elderly patients.
UNLABELLED: Information on the prognostic value of noninvasive stress imaging techniques in the elderly is relatively scarce. This study assessed the prognostic value of dobutamine stress (99m)Tc-tetrofosmin SPECT for the prediction of mortality and cardiac events in elderly patients. METHODS: Clinical information and SPECT results were analyzed for 272 consecutive patients > or = 65 y old (mean age, 71 +/- 5 y; range, 65-87 y) with limited exercise capacity. Follow-up was complete in 270 patients (99.3%); 23 underwent revascularization within 60 d of the scintigraphy and were excluded. Abnormal findings were defined as the presence of a fixed or reversible perfusion defect. A summed stress score was obtained to estimate the extent and severity of perfusion defects. The incremental prognostic value of SPECT over clinical data was evaluated according to 3 multivariate models, which included any SPECT abnormality, the presence of a fixed or reversible defect, and the summed stress score. RESULTS: During the follow-up (3.3 +/- 1.4 y), 59 patients died (29 cardiac deaths), 16 had a nonfatal infarction, and 49 underwent late revascularization. Abnormal scan findings were present for 140 patients (57%). The annual event rates for total mortality, cardiac death, and cardiac death or nonfatal infarction were, respectively, 3.2%, 0.2%, and 0.7% when scan findings were normal and, respectively, 9.5%, 4.3%, and 8% when scan findings were abnormal (all P < 0.0001). Multivariate analysis showed that abnormal scan findings, the presence of a fixed or reversible defect, and the summed stress score provided incremental prognostic information over clinical data. The presence of abnormal scan findings was independently associated with an increased risk for total mortality, cardiac death, and cardiac death or nonfatal infarction (respectively, hazard ratio 3.4 [95% CI, 1.8-6.5], 12.1 [95% CI, 2.9-51.5], and 9.0 [95% CI, 2.8-29.6]). CONCLUSION:Dobutamine stress (99m)Tc-tetrofosmin SPECT provides incremental prognostic information for the prediction of total mortality and cardiac events in elderly patients.
Authors: R Parker Ward; Mouaz H Al-Mallah; Gabriel B Grossman; Christopher L Hansen; Robert C Hendel; Todd C Kerwin; Benjamin D McCallister; Rupa Mehta; Donna M Polk; Peter L Tilkemeier; Aseem Vashist; Kim Allan Williams; David G Wolinsky; Edward P Ficaro Journal: J Nucl Cardiol Date: 2007 Nov-Dec Impact factor: 5.952
Authors: Olivier De Winter; Anja Velghe; Nico Van de Veire; Pieter De Bondt; Marc De Buyzere; Christophe Van De Wiele; Guy De Backer; Thierry C Gillebert; Rudi A Dierckx; Johan De Sutter Journal: J Nucl Cardiol Date: 2005 Nov-Dec Impact factor: 5.952
Authors: Deborah H Kwon; Venu Menon; Penny Houghtaling; Elizabeth Lieber; Richard C Brunken; Manuel D Cerqueira; Wael A Jaber Journal: Cardiovasc Diagn Ther Date: 2014-02
Authors: Stefan Roest; Hendrik J Boiten; Ron T van Domburg; Roelf Valkema; Arend F L Schinkel Journal: J Nucl Cardiol Date: 2016-07-05 Impact factor: 5.952
Authors: Maria João Vidigal Ferreira; Maria João Cunha; Anabela Albuquerque; Ana Paula Moreira; Domingos Ramos; Gracinda Costa; João Lima; Mariano Pego Journal: Int J Cardiovasc Imaging Date: 2013-06-04 Impact factor: 2.357