Exercise testing in elderly patients with coronary artery disease

Exercise Standards for Testing and Training

“…In 419 CAD patients Ͼ65 years, one study revealed that severe ST segment depression induced by cycle ergometry predicted triple-vessel disease. 101 Ischemic ST segment depression predicted an increased risk of cardiac death in another study of older patients with stable CAD. 102 Although not recommended for routine use in apparently healthy older adults, exercise testing has also demonstrated prognostic significance in such a population.…”

Exercise Standards for Testing and Training

“…211,294 In 419 CAD patients >65 years of age, one study revealed that severe ST-segment depression induced by cycle ergometry predicted triple-vessel disease. 295 Ischemic ST-segment depression predicted an increased risk of cardiac death in another study of older patients with stable CAD. 296 Although not recommended for routine use in apparently healthy older adults, exercise testing has also demonstrated prognostic significance in such a population.…”

Diagnostic and Prognostic Value of Stress Testing in Older Persons

“…Several studies have demonstrated that an ischemic ST segment response to treadmill or cycle exercise, usually defined by ≥0.1 mV horizontal or downsloping ST‐segment depression, is a useful diagnostic tool for CAD in older as well as younger patients 6,15–18 . As noted earlier, the sensitivity of the exercise ECG may actually be enhanced in the elderly, though at a cost of modestly reduced specificity 6,15 .…”

“…Others, however, have found similar sensitivity and specificity across age 16,17 . Using supine cycle ergometry, Samek et al 18 found that the magnitude of ST segment depression plus the resting pulmonary capillary wedge pressure correctly predicted 90% of patients >65 years with significant three‐vessel CAD, but misclassified 68% of those with one‐ and two‐vessel disease. Overall, the diagnostic utility of treadmill or cycle exercise for CAD appears similar in patients older and younger than 65 years of age.…”