Long-term prediction of mortality in elderly persons by dobutamine stress echocardiography

Elena Biagini, Abdou Elhendy, Arend F.L. Schinkel, Vittoria Rizzello, Jeroen J. Bax, Fabiola B. Sozzi, Miklos D. Kertai, Ron T. Van Domburg, Boudewijn J. Krenning, Angelo Branzi, Claudio Rapezzi, Maarten L. Simoons, Don Poldermans

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Abstract

Background. Dobutamine stress echocardiography (DSE) was shown to provide incremental prognostic information. However, its role in the prediction of mortality in elderly persons is not well defined. We assessed the value of DSE in the prediction of mortality and hard cardiac events during long-term follow-up in patients older than 65 years. Methods. We studied 1434 patients >65 years old (mean age 72 ± 3 years) who underwent DSE for evaluation of coronary artery disease. Ischemia was defined as new or worsening wall motion abnormalities. Follow-up events were total mortality and hard cardiac events (cardiac mortality and nonfatal myocardial infarction). Multivariable Cox regression analysis was used to identify the independent predictors of follow-up events. Results. Ischemia was detected in 675 patients (47%). Five hundred six patients (35%) had a normal study, and 253 (18%) had fixed wall motion abnormalities. During a mean follow-up of 6.5 years, 532 (37%) deaths occurred, of which 249 (17%) were due to cardiac causes. A nonfatal myocardial infarction occurred in 45 patients (3%). Independent predictors of all-cause mortality in a multivariate analysis model were age (hazard ratio [HR] 1.06; 95% confidence interval [CI], 1.05-1.08), male sex (HR 1.5; 95% CI, 1.2-1.8). hypertension (HR 1.2; 95% CI, 1.1-1.4), smoking (HR 1.3; 95% CI, 1.1-1.6), diabetes (HR 1.4; 95% CI, 1.1-1.8), rest wall motion abnormalities (HR 1.07; 95% CI, 1.06-1.09), and ischemia (HR 1.3; 95% CI, 1.1-1.6). Independent predictors of hard cardiac events were age (HR 1.07; 95% CI, 1.05-1.09), male sex (HR 1.3; 95% CI, 1.1-1.7), smoking (HR 1.3; 95% CI, 1.1-1.6), diabetes (HR 1.6; 95% CI, 1.2-2.2), rest wall motion abnormalities (HR 1.13; 95% CI, 1.12-1.16), and ischemia (HR 2.1; 95% CI, 1.5-2.8). Conclusion. DSE provides independent prognostic information to predict all-cause mortality and hard cardiac events in elderly patients.

Original languageEnglish
Pages (from-to)1333-1338
Number of pages6
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume60
Issue number10
DOIs
Publication statusPublished - Oct 2005

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ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology

Cite this

Biagini, E., Elhendy, A., Schinkel, A. F. L., Rizzello, V., Bax, J. J., Sozzi, F. B., Kertai, M. D., Van Domburg, R. T., Krenning, B. J., Branzi, A., Rapezzi, C., Simoons, M. L., & Poldermans, D. (2005). Long-term prediction of mortality in elderly persons by dobutamine stress echocardiography. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 60(10), 1333-1338. https://doi.org/10.1093/gerona/60.10.1333