The clinical value of single photon emission computed tomography myocardial perfusion imaging in cardiac risk stratification of very elderly patients (≥80 years) with suspected coronary artery disease
The role of single photon emission computed tomography myocardial perfusion imaging (SPECT MPI) in cardiac evaluation of the very elderly patients is unclear. We investigated the clinical value of SPECT MPI in very elderly patients (≥80 years) with suspected coronary artery disease (CAD) as well as...
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| Veröffentlicht in: | Journal of nuclear cardiology 2012-04, Vol.19 (2), p.244-255 |
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| creator | Nair, Sanjeev U. Ahlberg, Alan W. Mathur, Shishir Katten, Deborah M. Polk, Donna M. Heller, Gary V. |
| description | The role of single photon emission computed tomography myocardial perfusion imaging (SPECT MPI) in cardiac evaluation of the very elderly patients is unclear. We investigated the clinical value of SPECT MPI in very elderly patients (≥80 years) with suspected coronary artery disease (CAD) as well as in comparison to younger patients.
A retrospective analysis of prospectively collected data from 8,864 patients [1,093 patients ≥80 years (very elderly), 3,369 patients 65-79 years (elderly), and 4,402 patients 50-64 years (middle-aged)] with suspected CAD who underwent exercise and/or pharmacologic stress testing with SPECT MPI between 1996 and 2005 was performed. Clinical and SPECT MPI characteristics, cardiac event rates, early (≤60 days) cardiac catheterization and revascularization rates of very elderly patients were compared to that of younger patients. Mean follow-up for cardiac events (cardiac death or non-fatal myocardial infarction) was 1.9 ± 0.9 years. Very elderly patients with moderate to severely abnormal SSS had a significantly higher annualized cardiac event rate than those with mildly abnormal or normal study (9.6% vs 3.4% and 2.5% respectively, P |
| doi_str_mv | 10.1007/s12350-011-9477-6 |
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A retrospective analysis of prospectively collected data from 8,864 patients [1,093 patients ≥80 years (very elderly), 3,369 patients 65-79 years (elderly), and 4,402 patients 50-64 years (middle-aged)] with suspected CAD who underwent exercise and/or pharmacologic stress testing with SPECT MPI between 1996 and 2005 was performed. Clinical and SPECT MPI characteristics, cardiac event rates, early (≤60 days) cardiac catheterization and revascularization rates of very elderly patients were compared to that of younger patients. Mean follow-up for cardiac events (cardiac death or non-fatal myocardial infarction) was 1.9 ± 0.9 years. Very elderly patients with moderate to severely abnormal SSS had a significantly higher annualized cardiac event rate than those with mildly abnormal or normal study (9.6% vs 3.4% and 2.5% respectively, P < .001). Across all categories of SSS, very elderly patients had a significantly higher cardiac event rate as compared to younger patients (P < .001). Early cardiac catheterization and revascularization referrals in very elderly patients increased as a function of severity of ischemia on SPECT MPI (P < .001), although these referral rates were significantly lower in very elderly patients with mild to moderate and severe ischemia as compared to younger patients (P < .05).
In very elderly patients (≥80 years) with suspected CAD, SPECT MPI has prognostic and incremental value in the noninvasive cardiovascular assessment for risk stratification and may influence medical decisions.</description><identifier>ISSN: 1071-3581</identifier><identifier>EISSN: 1532-6551</identifier><identifier>DOI: 10.1007/s12350-011-9477-6</identifier><identifier>PMID: 22071954</identifier><language>eng</language><publisher>New York: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cardiology ; Comorbidity ; Computed tomography ; Connecticut - epidemiology ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - mortality ; Elderly ; Emissions ; Female ; Frail Elderly ; Geriatric Assessment - statistics & numerical data ; Humans ; Imaging ; Male ; medical instruments ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Myocardial infarction ; Myocardial Perfusion Imaging - statistics & numerical data ; Nuclear Medicine ; Original Article ; Prevalence ; prognosis ; Radiology ; Reproducibility of Results ; revascularization ; Risk Assessment ; Risk Factors ; Sensitivity and Specificity ; single-photon emission-computed tomography myocardial perfusion imaging ; Stratification ; Stress ; Survival Analysis ; Survival Rate ; Tomography, Emission-Computed, Single-Photon - statistics & numerical data ; Young Adult</subject><ispartof>Journal of nuclear cardiology, 2012-04, Vol.19 (2), p.244-255</ispartof><rights>2012 American Society of Nuclear Cardiology. Published by ELSEVIER INC. All rights reserved.</rights><rights>American Society of Nuclear Cardiology 2011</rights><rights>American Society of Nuclear Cardiology 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-e52257d305f7de3240765a0e81e79778208719250bf94f076e349fe7c572f7073</citedby><cites>FETCH-LOGICAL-c455t-e52257d305f7de3240765a0e81e79778208719250bf94f076e349fe7c572f7073</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12350-011-9477-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12350-011-9477-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22071954$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nair, Sanjeev U.</creatorcontrib><creatorcontrib>Ahlberg, Alan W.</creatorcontrib><creatorcontrib>Mathur, Shishir</creatorcontrib><creatorcontrib>Katten, Deborah M.</creatorcontrib><creatorcontrib>Polk, Donna M.</creatorcontrib><creatorcontrib>Heller, Gary V.</creatorcontrib><title>The clinical value of single photon emission computed tomography myocardial perfusion imaging in cardiac risk stratification of very elderly patients (≥80 years) with suspected coronary artery disease</title><title>Journal of nuclear cardiology</title><addtitle>J. Nucl. Cardiol</addtitle><addtitle>J Nucl Cardiol</addtitle><description>The role of single photon emission computed tomography myocardial perfusion imaging (SPECT MPI) in cardiac evaluation of the very elderly patients is unclear. We investigated the clinical value of SPECT MPI in very elderly patients (≥80 years) with suspected coronary artery disease (CAD) as well as in comparison to younger patients.
A retrospective analysis of prospectively collected data from 8,864 patients [1,093 patients ≥80 years (very elderly), 3,369 patients 65-79 years (elderly), and 4,402 patients 50-64 years (middle-aged)] with suspected CAD who underwent exercise and/or pharmacologic stress testing with SPECT MPI between 1996 and 2005 was performed. Clinical and SPECT MPI characteristics, cardiac event rates, early (≤60 days) cardiac catheterization and revascularization rates of very elderly patients were compared to that of younger patients. Mean follow-up for cardiac events (cardiac death or non-fatal myocardial infarction) was 1.9 ± 0.9 years. Very elderly patients with moderate to severely abnormal SSS had a significantly higher annualized cardiac event rate than those with mildly abnormal or normal study (9.6% vs 3.4% and 2.5% respectively, P < .001). Across all categories of SSS, very elderly patients had a significantly higher cardiac event rate as compared to younger patients (P < .001). Early cardiac catheterization and revascularization referrals in very elderly patients increased as a function of severity of ischemia on SPECT MPI (P < .001), although these referral rates were significantly lower in very elderly patients with mild to moderate and severe ischemia as compared to younger patients (P < .05).
In very elderly patients (≥80 years) with suspected CAD, SPECT MPI has prognostic and incremental value in the noninvasive cardiovascular assessment for risk stratification and may influence medical decisions.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cardiology</subject><subject>Comorbidity</subject><subject>Computed tomography</subject><subject>Connecticut - epidemiology</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Coronary Artery Disease - mortality</subject><subject>Elderly</subject><subject>Emissions</subject><subject>Female</subject><subject>Frail Elderly</subject><subject>Geriatric Assessment - statistics & numerical data</subject><subject>Humans</subject><subject>Imaging</subject><subject>Male</subject><subject>medical instruments</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Myocardial Perfusion Imaging - statistics & numerical data</subject><subject>Nuclear Medicine</subject><subject>Original Article</subject><subject>Prevalence</subject><subject>prognosis</subject><subject>Radiology</subject><subject>Reproducibility of Results</subject><subject>revascularization</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>single-photon emission-computed tomography myocardial perfusion imaging</subject><subject>Stratification</subject><subject>Stress</subject><subject>Survival Analysis</subject><subject>Survival Rate</subject><subject>Tomography, Emission-Computed, Single-Photon - statistics & numerical data</subject><subject>Young Adult</subject><issn>1071-3581</issn><issn>1532-6551</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kk9u1TAQxiMEoqVwADbIYkNZBGwnfo7VFar4J1ViU9aR60zec0ni4HEeyhG4BRsuwpZbcBImTQGJxVvZ8vy-b-SZL8seC_5CcK5fopCF4jkXIjel1vnmTnYsVCHzjVLiLt25FnmhKnGUPUC85pybwpj72ZGUVDGqPM5-Xu6Auc4P3tmO7W03AQstQz9sO2DjLqQwMOg9oqeLC_04JWhYCn3YRjvuZtbPwdnYeJKPENvpBvS93ZIF86S5KToWPX5imKJNvqVmacGo0x7izKBrIHYzG-kZhoTs9NfX7xX_8W0GG_E5--LTjuGEI7iluwsxDJZ0NqZF3ngEi_Awu9faDuHR7XmSfXzz-vL8XX7x4e3781cXuSuVSjkoKZVuCq5a3UAhS643ynKoBGijdSV5RcORil-1pmypCEVpWtBOadlqrouT7NnqO8bweQJMNc3HQdfZAcKEtaEV8IrrisjTg6SghZRlUZWS0Kf_oddhigP9ozYlN1pWfPETK-RiQIzQ1mOkUceZnOolEvUaiZoiUS-RqDekeXJrPF310PxV_MkAAXIFkErDFuK_zodcz1YR0KD3nkToaHUOGh9pSXUT_AH1by132as</recordid><startdate>20120401</startdate><enddate>20120401</enddate><creator>Nair, Sanjeev U.</creator><creator>Ahlberg, Alan W.</creator><creator>Mathur, Shishir</creator><creator>Katten, Deborah M.</creator><creator>Polk, Donna M.</creator><creator>Heller, Gary V.</creator><general>Elsevier Inc</general><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>20120401</creationdate><title>The clinical value of single photon emission computed tomography myocardial perfusion imaging in cardiac risk stratification of very elderly patients (≥80 years) with suspected coronary artery disease</title><author>Nair, Sanjeev U. ; 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Nucl. Cardiol</stitle><addtitle>J Nucl Cardiol</addtitle><date>2012-04-01</date><risdate>2012</risdate><volume>19</volume><issue>2</issue><spage>244</spage><epage>255</epage><pages>244-255</pages><issn>1071-3581</issn><eissn>1532-6551</eissn><abstract>The role of single photon emission computed tomography myocardial perfusion imaging (SPECT MPI) in cardiac evaluation of the very elderly patients is unclear. We investigated the clinical value of SPECT MPI in very elderly patients (≥80 years) with suspected coronary artery disease (CAD) as well as in comparison to younger patients.
A retrospective analysis of prospectively collected data from 8,864 patients [1,093 patients ≥80 years (very elderly), 3,369 patients 65-79 years (elderly), and 4,402 patients 50-64 years (middle-aged)] with suspected CAD who underwent exercise and/or pharmacologic stress testing with SPECT MPI between 1996 and 2005 was performed. Clinical and SPECT MPI characteristics, cardiac event rates, early (≤60 days) cardiac catheterization and revascularization rates of very elderly patients were compared to that of younger patients. Mean follow-up for cardiac events (cardiac death or non-fatal myocardial infarction) was 1.9 ± 0.9 years. Very elderly patients with moderate to severely abnormal SSS had a significantly higher annualized cardiac event rate than those with mildly abnormal or normal study (9.6% vs 3.4% and 2.5% respectively, P < .001). Across all categories of SSS, very elderly patients had a significantly higher cardiac event rate as compared to younger patients (P < .001). Early cardiac catheterization and revascularization referrals in very elderly patients increased as a function of severity of ischemia on SPECT MPI (P < .001), although these referral rates were significantly lower in very elderly patients with mild to moderate and severe ischemia as compared to younger patients (P < .05).
In very elderly patients (≥80 years) with suspected CAD, SPECT MPI has prognostic and incremental value in the noninvasive cardiovascular assessment for risk stratification and may influence medical decisions.</abstract><cop>New York</cop><pub>Elsevier Inc</pub><pmid>22071954</pmid><doi>10.1007/s12350-011-9477-6</doi><tpages>12</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Cardiology Comorbidity Computed tomography Connecticut - epidemiology Coronary Artery Disease - diagnostic imaging Coronary Artery Disease - mortality Elderly Emissions Female Frail Elderly Geriatric Assessment - statistics & numerical data Humans Imaging Male medical instruments Medicine Medicine & Public Health Middle Aged Mortality Myocardial infarction Myocardial Perfusion Imaging - statistics & numerical data Nuclear Medicine Original Article Prevalence prognosis Radiology Reproducibility of Results revascularization Risk Assessment Risk Factors Sensitivity and Specificity single-photon emission-computed tomography myocardial perfusion imaging Stratification Stress Survival Analysis Survival Rate Tomography, Emission-Computed, Single-Photon - statistics & numerical data Young Adult |
| title | The clinical value of single photon emission computed tomography myocardial perfusion imaging in cardiac risk stratification of very elderly patients (≥80 years) with suspected coronary artery disease |
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