[Mechanism of silent myocardial ischemia in elderly patients with coronary artery disease--assessment by dipyridamole thallium scintigraphy]
| Autor: | Takashi Furuno, Hiroaki Kitaoka, Taishiro Chikamori, Yoshihisa Matsumura, Fumiyasu Yamasaki, Toshikazu Yabe, Takao Murai, Yoshinori Doi |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Infarction Coronary Disease Scintigraphy Coronary Angiography Coronary artery disease Angioplasty Internal medicine medicine Humans Myocardial infarction Radionuclide Imaging Aged ST depression Aged 80 and over medicine.diagnostic_test business.industry Heart Dipyridamole medicine.disease Thallium Radioisotopes Cardiology Female Myocardial infarction diagnosis Geriatrics and Gerontology medicine.symptom business medicine.drug |
| Zdroj: | Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics. 34(5) |
| ISSN: | 0300-9173 |
| Popis: | To evaluate the clinical significance of silent myocardial ischemia in elderly patients with coronary artery disease, 147 patients (aged 65 years and older) underwent coronary angiography and dipyridamole thallium scintigraphy. Seventy-four patients (44 men, 30 women) who showed reversible defects (RD) and ischemic ST depression during scintigraphy were divided into two groups: 13 with silent RD (18%, 12 men, 1 woman), and 61 with painful RD (82%, 32 men, 29 women). Most patients with silent RD were men. The prevalence of myocardial infarction was similar in patients with silent RD (62%) and in patients with painful RD (49%). The prevalence of multivessel disease was also similar in the two groups: 85% in patients with silent RD and 82% in patients with painful RD. Among 38 patients with infarction, 8 had silent RD and 30 had painful RD. The prevalence of RD in the area of infarction was greater in patients with silent RD (63%) than in patients with painful RD (47%), but the difference was not statistically significant. The prevalence of extensive infarction (fixed defects) was greater in patients with silent RD (75%) than in patients with painful RD (30%, p < 0.05). Among 36 patients without infarction, there was no scintigraphic parameter which showed significant difference. Bypass grafting and angioplasty were initially performed in 23% of the patients with silent RD and in 36% of the patients with painful RD (ns). When the two groups were treated medically during the follow-up period of 29 +/- 22 months, the incidences of cardiac events were similar: 10% in patients with silent RD and 13% in patients with painful RD. The prevalence of silent RD is not high in elderly patients with significant coronary artery disease. Compared with the patients with painful RD, those with silent RD were more likely to have an old and extensive myocardial infarction, and they tended to have RD in the area of the infarct. |
| Databáze: | OpenAIRE |
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