Stress echocardiography for predicting cardiac events in octogenarians: is myocardial perfusion scintigraphy...

The use of stress echocardiography (SE) in an elderly population was retrospectively evaluated and compared with myocardial perfusion scintigraphy (MPS) in a similar group. Patients > or = 80 years of age were evaluated by treadmill or pharmacologic SE (group 1; n = 65) to determine its predictive value for cardiac events. A second group had MPS (group 2; n = 68). We identified 11 patients in group 1 and 25 in group 2 who had a cardiac event, with no statistical significance between the positive predictive value of SE and MPS (55% vs 49%) and the negative predictive value of SE and MPS (89% vs 73%). The actuarial event-free survival was better for patients with negative SE than for patients with positive SE or negative or positive MPS. This study suggests that SE is comparable to MPS as a prognosticator of cardiac events in octogenarians. The retrospective design and the small population studied are major limitations. A larger, prospective trial should be launched to analyze this group and compare various stress tests.