Functional and prognostic significance of silent ischemia during dobutamine stress echocardiography in the elderly

BACKGROUNDThe functional and prognostic significance of silent ischemia relative to symptomatic ischemia during non-invasive testing remains controversial. DESIGNThe aim of this prospective study was to assess whether the presence of dobutamine-induced silent ischemia was associated with the amount of myocardial ischemic burden and to determine the prognostic significance of painless ischemia in elderly people with stable coronary artery disease. METHODSA cohort of 289 patients ≥70 years of age with positive dobutamine stress echocardiography result and significant coronary artery disease proven by coronary arteriography, were followed up during a 35 ± 13 month period for the development of cardiac events. RESULTSThe prevalence of silent ischemia during dobutamine infusion was 63%. Patients with painful ischemia were more likely to have lower peak heart rate (P