Chest
Exercise and the HeartPrognostic Value of Stress Testing in Patients Over 75 Years of Age With Chronic Angina
Section snippets
Patients
Enrolled into the TIME study were 301 patients aged ≥ 75 years who were referred to one of 14 Swiss centers for assessment of class 2 or greater angina pectoris according to the classification of the Canadian Cardiovascular Society (CCS) despite having received at least two antianginal drugs. In every patient, STRT was recommended as part of a routine clinical evaluation in order to document angina/ischemia despite receiving standard antianginal therapy. Then, and after informed consent had
Patients and Stress Tests
In 292 of the 301 TIME study patients (97%), pertinent STRT data were available. In the remaining nine patients (3%), test data were not available for unreported reasons, and the patients were excluded from this analysis. The 292 patients formed the study population for the present analysis.
STRT could be performed in 148 of these 292 study patients (51%), whereas a test was not performed in 95 patients (33%) because of severe or unstable symptoms, in 24 patients (8%) because of limiting
Discussion
The present analysis of the prognostic power of STRT in 80-year-old patients with chronic angina despite receiving standard medical therapy shows the following several important findings. First, a symptom-limited exercise test is possible in more than half of these patients. Second, the test provides prognostic value despite concurrent antianginal drug therapy. Regarding nonfatal MI and the combined death/nonfatal MI end point, patients who could perform STRT had a better outcome than patients
Conclusions
This outcome analysis of 80-year-old patients with chronic angina despite receiving standard antianginal therapy shows that STRT is feasible in more than half of these patients and adds relevant information to their management. Patients with provocable ischemia despite receiving antianginal therapy and those unable to perform STRT due to unstable symptoms have sixfold and eightfold the risk of death/nonfatal MI, respectively, than patients without ischemia, and they may benefit particularly
ACKNOWLEDGMENT
We gratefully acknowledge the contribution of all participating patients, and the work done by all investigators, advisors, and the critical event committee.
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Cited by (0)
The TIME study was supported by grants from the Swiss Heart Foundation and the Adumed Foundation, Switzerland.