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A noninvasive heart scan may help identify which senior adults are at the greatest risk for cardiac death, according to a study presented at the recent 73rd Scientific Sessions of the American Heart Association in New Orleans. In addition, researchers say that their findings suggest that more aggressive treatment may be warranted in those elderly patients with only mild cardiac ischemia than is currently used in clinical practice.
Researchers evaluated the prognostic value of stress-induced ischemia in 15,081 patients referred for myocardial perfusion SPECT (single photon emission computed tomography) using Cardiolite (Kit for the Preparation of Technetium Tc99m Sestamibi for injection). Patients’ risks were determined by the amount of ischemia evident on SPECT and adjusted by decade of life from less than 60 years of age to 80 years of age and older. The statistical threshold of increased cardiac death decreased with advancing age, researchers reported. Specifically, 18-month survival rate was 99% for 70 years or younger, 98% for 71 to 80, and 94% for older than 80.
The findings demonstrate, says lead researcher Leslee J. Shaw, PhD, associate professor of med-icine at Emory University in Atlanta, that the ability of a noninvasive heart scan to accurately detect and assess the degree of cardiac ischemia is critical to early intervention and the long-term survival of patients. "With this new clinical evidence, we are another step closer to improving the management of this often undertreated patient population," he argues.
"While physicians already know the clinical value of Cardiolite in the general population, this study further points to its ability to accurately predict risk of cardiac death and guide clinical decisions in older patients," says Daniel Berman, MD, a study investigator and director of nuclear cardiology at Cedars-Sinai Medical Center in Los Angeles.
"Furthermore, the findings of this study take on even greater significance when you consider that cardiac ischemia is the leading cause of death among elderly patients and that the elderly comprise an increasing percentage of the U.S. population," he explains.