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

Translated title of the contribution: In comparison to the myocardial perfusion scintigraphy, a treadmill stress test is a viable, efficient and cost effective option to predict cardiovascular events in elderly patients

Luciano Janussi Vacanti, Andrei Carvalho Sposito, Luciano Séspedes, Maíra Sarpi, José Antonio F Ramires, Anna Bortnick

Research output: Contribution to journalArticle

6 Citations (Scopus)

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 languageUndefined
Pages (from-to)531-536
Number of pages6
JournalArquivos Brasileiros de Cardiologia
Volume88
Issue number5
StatePublished - May 2007
Externally publishedYes

Fingerprint

Myocardial Perfusion Imaging
Perfusion Imaging
Exercise Test
Costs and Cost Analysis
Myocardial Revascularization
Dipyridamole
Acute Coronary Syndrome
Dyslipidemias
Cost-Benefit Analysis
Myocardial Ischemia
Heart Rate

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 journalArticle

Vacanti, Luciano Janussi ; Sposito, Andrei Carvalho ; Séspedes, Luciano ; Sarpi, Maíra ; Ramires, José Antonio F ; Bortnick, Anna. / 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. In: Arquivos Brasileiros de Cardiologia. 2007 ; Vol. 88, No. 5. pp. 531-536.
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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.",
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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

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