[Age-related changes in clinical and prognostic significance of exercise-induced angina]

Exercise-induced angina (EA) is an important manifestation of myocardial ischemia in stress testing. However, whether or not the presence of EA indicates a greater severity and worse prognosis of coronary artery disease is uncertain. It is well known that the elderly have a greater prevalence of silent myocardial infarction. This suggests that the incidence and significance of EA in elderly patients may differ from those in the younger patients. Therefore, we, at first, studied the age-related change in the incidence of EA by reviewing 983 consecutive treadmill tests. Furthermore, to evaluate the age-related change of the clinical and prognostic significance of EA, exercise tests, angiographic findings and 29 months follow-up data were assessed in 142 patients without prior myocardial infarction who underwent treadmill test and coronary angiography (CAG) for the investigation of coronary artery disease. The rate of positive test results among 983 treadmill tests exceeded 30% only in patients 60 years old or older. Accordingly, we divided the patients into two different age groups: middle-aged patients (less than or equal to 59 yr, M-patients) and elderly patients (greater than or equal to 60 yr, O-patients). Among 983 treadmill tests, O-patients had a higher rate of positive results (presence of EA or positive ECG criteria) than M-patients (36 vs. 24%, p less than 0.001). However, incidence of EA was similar in the 2 groups (17 vs. 14%).(ABSTRACT TRUNCATED AT 250 WORDS)