Exercise Single-Photon Emission Computed Tomography Provides Effective Risk Stratification of Elderly Men and Elderly Women
| Autor: | David O. Hodge, Uma S. Valeti, Todd D. Miller, Raymond J. Gibbons |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Male
medicine.medical_specialty Population Physical exercise Coronary Artery Disease Risk Assessment Severity of Illness Index Sex Factors Predictive Value of Tests Physiology (medical) Internal medicine Humans Medicine Risk factor education Aged Retrospective Studies Aged 80 and over Tomography Emission-Computed Single-Photon education.field_of_study business.industry Retrospective cohort study Prognosis Survival Analysis Surgery SSS Thallium Radioisotopes Predictive value of tests Cohort Exercise Test Cardiology Female Cardiology and Cardiovascular Medicine business Risk assessment Follow-Up Studies |
| Zdroj: | Circulation. 111:1771-1776 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/01.cir.0000160862.36124.8e |
| Popis: | Background— In a recent study, we reported that the Duke treadmill score was unable to effectively stratify elderly patients according to risk. The purpose of this study was to evaluate the prognostic value of exercise single-photon emission computed tomography (SPECT) in this same population and to examine results by gender. Methods and Results— A cohort of 247 elderly (age ≥75 years) patients (108 women, 139 men, age 77±3 years) who underwent exercise thallium-201 SPECT were followed up for a median duration of 6.4 years. SPECT variables were significantly associated with cardiac death: summed stress score (SSS) χ 2 =19.5, P 2 =12.3, P 2 =9.6, P =0.002; and left ventricular enlargement χ 2 =8.3, P =0.004. The Duke score was not significantly associated with cardiac death (χ 2 P =NS). The SSS classified most patients as low risk (49%) or high risk (35%); the Duke score classified the majority (68%) as intermediate risk. Annual cardiac mortality rates for patients categorized by SSS as low risk and high risk were 0.8% and 5.8%, respectively. Cardiac survival rates according to SSS risk categories were significantly different for both women ( P =0.012) and men ( P =0.003). Conclusions— SPECT classified most elderly patients into clinically useful low- and high-risk categories and accurately predicted outcomes in both genders. If these results can be validated in future studies, exercise SPECT rather than standard treadmill testing may emerge as the initial noninvasive testing strategy in elderly patients who are able to exercise. |
| Databáze: | OpenAIRE |
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