Abstract
Objective: To define the prognostic value and cost-effectiveness of the treadmill stress test (TST) in comparison to the dipyridamole myocardial perfusion scintigraphy (DIP), in individuals ≥75 years of age. Methods: Consecutive and prospective assessment of 66 patients (40% male) aged 81 ± 5 years of which 57% were hypertensive, 38% had dyslipidemia and 28% were diabetics. The Bruce protocol was adapted for a tilt treadmill and the TST prognostic value was obtained using the Duke treadmill score. Results: The TST duration, recommended maximum heart rate percentage and double product at peak exercise were respectively: 7 ± 3 minutes, 95 ± 9% and 24,946 ± 4,576 (bpm x mmHg). The TST and DIP presented similar positive results for myocardial ischemia (21% vs 15%, respectively). The correlation between the tests was 88% (Kappa 0.63, p<0.01). During 685 ± 120 days of follow-up, nine major events occurred: 6 deaths, 2 acute coronary syndromes and 1 myocardial revascularization. The variables associated with the major events were: age (83 ± 6 vs 80 ± 4 years; p=0.048), male gender (78% vs 33%; p=0.02), ST segment depression (1 ± 1 mm vs 0.25 ± 0.6 mm; p= 0.01), high or intermediate risk determined by the Duke treadmill score - combined in one group (44% vs 2%; p=0.001) and abnormal DIP (44% vs 10%, p= 0.02). Conclusion: For this elderly population, the TST was an efficient and viable option with a similar diagnostic value in comparison to the DIP. However, the TST was more accurate in the prediction of major events and offers a lower cost.
| Original language | Undefined |
|---|---|
| Pages (from-to) | 531-536 |
| Number of pages | 6 |
| Journal | Arquivos Brasileiros de Cardiologia |
| Volume | 88 |
| Issue number | 5 |
| State | Published - May 2007 |
| Externally published | Yes |
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Keywords
- Aged, 80 and over
- Cardiovascular diseases
- Costo-benefit analysis
- Efficacy
- Exercise test
- Radionuclide imaging
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
O teste ergométrico é factível, eficaz e custo-efetivo na predição de eventos cardiovasculares no paciente muito idoso, quando comparado à cintilografia de perfusão miocárdica. / Vacanti, Luciano Janussi; Sposito, Andrei Carvalho; Séspedes, Luciano; Sarpi, Maíra; Ramires, José Antonio F; Bortnick, Anna.
In: Arquivos Brasileiros de Cardiologia, Vol. 88, No. 5, 05.2007, p. 531-536.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - O teste ergométrico é factível, eficaz e custo-efetivo na predição de eventos cardiovasculares no paciente muito idoso, quando comparado à cintilografia de perfusão miocárdica
AU - Vacanti, Luciano Janussi
AU - Sposito, Andrei Carvalho
AU - Séspedes, Luciano
AU - Sarpi, Maíra
AU - Ramires, José Antonio F
AU - Bortnick, Anna
PY - 2007/5
Y1 - 2007/5
N2 - Objective: To define the prognostic value and cost-effectiveness of the treadmill stress test (TST) in comparison to the dipyridamole myocardial perfusion scintigraphy (DIP), in individuals ≥75 years of age. Methods: Consecutive and prospective assessment of 66 patients (40% male) aged 81 ± 5 years of which 57% were hypertensive, 38% had dyslipidemia and 28% were diabetics. The Bruce protocol was adapted for a tilt treadmill and the TST prognostic value was obtained using the Duke treadmill score. Results: The TST duration, recommended maximum heart rate percentage and double product at peak exercise were respectively: 7 ± 3 minutes, 95 ± 9% and 24,946 ± 4,576 (bpm x mmHg). The TST and DIP presented similar positive results for myocardial ischemia (21% vs 15%, respectively). The correlation between the tests was 88% (Kappa 0.63, p<0.01). During 685 ± 120 days of follow-up, nine major events occurred: 6 deaths, 2 acute coronary syndromes and 1 myocardial revascularization. The variables associated with the major events were: age (83 ± 6 vs 80 ± 4 years; p=0.048), male gender (78% vs 33%; p=0.02), ST segment depression (1 ± 1 mm vs 0.25 ± 0.6 mm; p= 0.01), high or intermediate risk determined by the Duke treadmill score - combined in one group (44% vs 2%; p=0.001) and abnormal DIP (44% vs 10%, p= 0.02). Conclusion: For this elderly population, the TST was an efficient and viable option with a similar diagnostic value in comparison to the DIP. However, the TST was more accurate in the prediction of major events and offers a lower cost.
AB - Objective: To define the prognostic value and cost-effectiveness of the treadmill stress test (TST) in comparison to the dipyridamole myocardial perfusion scintigraphy (DIP), in individuals ≥75 years of age. Methods: Consecutive and prospective assessment of 66 patients (40% male) aged 81 ± 5 years of which 57% were hypertensive, 38% had dyslipidemia and 28% were diabetics. The Bruce protocol was adapted for a tilt treadmill and the TST prognostic value was obtained using the Duke treadmill score. Results: The TST duration, recommended maximum heart rate percentage and double product at peak exercise were respectively: 7 ± 3 minutes, 95 ± 9% and 24,946 ± 4,576 (bpm x mmHg). The TST and DIP presented similar positive results for myocardial ischemia (21% vs 15%, respectively). The correlation between the tests was 88% (Kappa 0.63, p<0.01). During 685 ± 120 days of follow-up, nine major events occurred: 6 deaths, 2 acute coronary syndromes and 1 myocardial revascularization. The variables associated with the major events were: age (83 ± 6 vs 80 ± 4 years; p=0.048), male gender (78% vs 33%; p=0.02), ST segment depression (1 ± 1 mm vs 0.25 ± 0.6 mm; p= 0.01), high or intermediate risk determined by the Duke treadmill score - combined in one group (44% vs 2%; p=0.001) and abnormal DIP (44% vs 10%, p= 0.02). Conclusion: For this elderly population, the TST was an efficient and viable option with a similar diagnostic value in comparison to the DIP. However, the TST was more accurate in the prediction of major events and offers a lower cost.
KW - Aged, 80 and over
KW - Cardiovascular diseases
KW - Costo-benefit analysis
KW - Efficacy
KW - Exercise test
KW - Radionuclide imaging
UR - http://www.scopus.com/inward/record.url?scp=34347338854&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34347338854&partnerID=8YFLogxK
M3 - Article
VL - 88
SP - 531
EP - 536
JO - Arquivos Brasileiros de Cardiologia
JF - Arquivos Brasileiros de Cardiologia
SN - 0066-782X
IS - 5
ER -