Document Detail


Prognostic significance of exercise thallium-201 testing in patients aged greater than or equal to 70 years with known or suspected coronary artery disease.
MedLine Citation:
PMID:  1729866     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The prognostic value of exercise thallium-201 myocardial perfusion imaging has not been studied in an elderly (aged greater than or equal to 70 years) population. Retrospective analysis of 120 consecutive elderly patients undergoing Bruce protocol exercise stress with quantitative planar thallium-201 scintigraphy, followed clinically for a mean of 36 +/- 12 months after testing, revealed a 10% cardiac event rate (6 cardiac deaths from arrhythmia or congestive heart failure, and 5 fatal and 1 nonfatal myocardial infarction). There were no exercise stress-related complications. Survival without cardiac events was associated with greater exercise duration (5.6 +/- 2.4 vs 3.1 +/- 2.4 minutes; p less than 0.0007) and peak exercise heart rate (131 +/- 18 vs 120 +/- 19 beats/min; p less than 0.05). Univariate variables associated with higher cardiac event rates included: (1) peak exercise less than or equal to stage I (18 vs 6%; p = 0.04); (2) maximal ST-segment depression greater than or equal to 2 mm (27 vs 6%; p = 0.003); and (3) presence of a fixed or reversible thallium-201 perfusion defect (18 vs 2%; p = 0.004). Multivariate stepwise logistic regression analysis identified the combination of peak exercise less than or equal to stage I and any thallium-201 perfusion defect as the most powerful predictor of subsequent cardiac events (relative risk = 5.3 at 1 year). Thus, exercise thallium-201 scintigraphy in elderly patients is safe and provides important prognostic information.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
T C Hilton; L J Shaw; B R Chaitman; K S Stocke; H M Goodgold; D D Miller
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  69     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1992 Jan 
Date Detail:
Created Date:  1992-02-10     Completed Date:  1992-02-10     Revised Date:  2007-09-04    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  45-50     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, St. Louis University Medical Center, Missouri 63110-0250.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Analysis of Variance
Chi-Square Distribution
Coronary Disease / physiopathology,  radionuclide imaging*
Exercise Test*
Female
Heart Rate
Humans
Life Tables
Male
Prognosis
Regression Analysis
Retrospective Studies
Survival Analysis
Thallium Radioisotopes / diagnostic use*
Chemical
Reg. No./Substance:
0/Thallium Radioisotopes

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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