Long-term prognostic implications of myocardial perfusion imaging in octogenarians: an all-comer, cohort study

Abstract

In octogenarians, MPI provides effective long-term risk stratification, regardless of stress type used or underlying cardiac function.

Role of myocardial perfusion scintigraphy in octogenarians: Time for reappraisal?

“…Notably, in the current retrospective analysis, 1 the diagnostic accuracy of MPS was similar among both groups (area under the curve (AUC) for, e.g., two or three vessel disease: 0.54 vs 0.58), while the prognostic accuracy was higher or comparable between octogenarians and the younger group for death (hazard ratio (HR):10.7 vs 2.72), myocardial infarction (HR: 1.06 vs 1.24), or their combination (HR: 4.93 vs 1.87). Such findings accord with other investigations 3,[7][8][9] that octogenarians are likely to have both elevated incidence and mortality from CAD as compared to the younger population. Despite similar diagnostic and prognostic accuracy of MPS in both groups, coronary revascularization was non-significantly lower in octogenarians (3.71% vs 6.96%, p = 0.068).…”

“…When comparing these two groups, octogenarians had more severe and extensive myocardial ischemia, while coronary artery disease (CAD) was more pronounced and diffuse. Like in previous investigations, [2][3][4][5][6][7] octogenarians had a significantly higher major adverse cardiac event rate than in younger patients during a mean follow-up period of 32 months. Notably, in the current retrospective analysis, 1 the diagnostic accuracy of MPS was similar among both groups (area under the curve (AUC) for, e.g., two or three vessel disease: 0.54 vs 0.58), while the prognostic accuracy was higher or comparable between octogenarians and the younger group for death (hazard ratio (HR):10.7 vs 2.72), myocardial infarction (HR: 1.06 vs 1.24), or their combination (HR: 4.93 vs 1.87).…”

“…Similarly, Nudi et al 1 demonstrated that the extent and severity of myocardial ischemia was also paralleled by a worsened cardiovascular outcome but the current study expands it now to octogenarians in a relatively high numbers of 517 individuals. Thus, current 1 and previous MPS studies 2,3,6,7 signify that MPS may indeed be of help in identifying elderly patients, even when exceeding 80 years, at risk for cardiovascular events. In particular, Nudi et al 1 could demonstrate with a propensity-matched analysis that the MPS-related diagnostic and prognostic accuracy was similar or even better in octogenarians than in younger patients.…”

The effects of terbinafine on the lipid profile in humans and rabbits

“…From the present review it appears that ketoconazole has a hypocholesterolemic potential (Stalenhoef et al, 1997). Terbinafine caused hypertriglyceridemia but there is a lack of information regarding the effect of this drug on other lipid parameters (Katsikis et al, 2017). Because of that it was felt necessary to investigate in detail the effect of this antifungal drug namely the allylamine terbinafine on the lipid profile in patients attending KKUH dermatology clinics as well as in normolipidemic rabbits.…”