Document Detail


Stress echocardiography in elderly patients with coronary artery disease: applicability, safety and prognostic value of dobutamine and adenosine echocardiography in elderly patients.
MedLine Citation:
PMID:  8752794     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Our aim was to determine the applicability, safety and prognostic value of adenosine and dobutamine stress echocardiography in patients > or = 70 years old. BACKGROUND: These tests are sometimes mandatory because of difficulties and inaccuracies in interpreting traditional electrocardiographic stress tests. Furthermore, if these tests could be used to avoid coronary arteriography and cardiac catheterization, they would become essential in the care of the elderly, whose numbers are increasing. METHODS: We performed coronary arteriography and dobutamine and adenosine stress echocardiographic tests in 120 patients (72 men) > or = 70 years old who entered the hospital because of chest pain and had known or suspected coronary artery disease. The stress tests were performed on separate days, within 2 weeks of coronary arteriography. Both the arteriograms and the echocardiograms were analyzed by two experts who had no knowledge of the patients' other data or the other interpreter's report. Tests were judged to have positive or negative results, and the patients were followed up for the development of cardiac events. Univariate and multivariate analyses and other statistical modalities were applied for comparisons. RESULTS: Documented coronary artery disease was found in 89 patients. During the 14 +/- 7 of follow-up, cardiac events developed in 50 patients, including 3 (7.9%) of 38 patients with negative dobutamine and 12 (20.7%) of 58 patients with negative adenosine test results. Demonstration of any abnormality on stress echocardiography was an independent factor for cardiac events, both for dobutamine (relative risk 7.3) and for adenosine (relative risk 3.0). Both cessation of dobutamine or adenosine tests and diagnosis of disease in two or more coronary vessels were also independent predictors. ST segment depression > or = 1mm was related to future events only with the dobutamine test. CONCLUSIONS: These echocardiographic stress tests proved safe and well tolerated. They successfully stratified this cohort of elderly patients with coronary artery disease to low or high risk subgroups for subsequent cardiac events.
Authors:
L P Anthopoulos; M S Bonou; F G Kardaras; E P Sioras; D N Kardara; A M Sideris; A I Kranidis; N G Margaris
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  28     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1996 Jul 
Date Detail:
Created Date:  1996-10-11     Completed Date:  1996-10-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  52-9     Citation Subset:  AIM; IM    
Affiliation:
First Department of Cardiology and Hemodynamic Laboratory, The Evangelismos Hospital, Athens, Greece.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / adverse effects,  diagnostic use*
Adrenergic beta-Agonists / adverse effects,  diagnostic use*
Aged
Coronary Angiography
Coronary Disease / diagnosis,  epidemiology,  ultrasonography*
Dobutamine / adverse effects,  diagnostic use*
Echocardiography / methods*
Female
Follow-Up Studies
Humans
Male
Predictive Value of Tests
Regression Analysis
Risk Factors
Safety
Sensitivity and Specificity
Time Factors
Vasodilator Agents / adverse effects,  diagnostic use*
Chemical
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Vasodilator Agents; 34368-04-2/Dobutamine; 58-61-7/Adenosine

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


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