teste ergométrico: valor prognóstico em pacientes idosos com doença aterosclerótica coronariana estável exercise stress test: prognostic value for elderly patients with stable coronary atherosclerosis

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ID: 155151
2006
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Abstract
OBJETIVO: Estudar o valor prognóstico das variáveis do teste ergométrico em pacientes idosos com doença aterosclerótica coronariana e isquemia induzida pelo esforço. MÉTODOS: Foram estudados 64 pacientes idosos (61 homens, idade de 73 ± 5 anos) com doença aterosclerótica coronariana, comprovada por coronariografia, clinicamente estável, fração de ejeção de ventrículo esquerdo maior ou igual a 0,40 e isquemia miocárdica durante o teste ergométrico. A cada seis meses, os pacientes foram avaliados para eventos cardíacos (morte, infarto do miocárdio, angina instável, angioplastia e revascularização do miocárdio). RESULTADOS: Após seguimento médio de 48 meses, 23 (36%) pacientes sofreram eventos cardíacos. Não houve diferença clínica e angiográfica entre os pacientes que sofreram o evento e os que não o sofreram. Pela análise multivariada, a presença de dor precordial durante o teste ergométrico (risco relativo de 2,668 e p = 0,031) e a freqüência cardíaca no início da isquemia (risco relativo de 0,966 e p = 0,009) foram associadas a eventos cardíacos. CONCLUSÃO: Nessa população idosa, a presença de dor precordial durante o teste ergométrico e a freqüência cardíaca no início da isquemia foram associadas a eventos cardíacos. Essas variáveis podem ser úteis para avaliação do risco de pacientes com doença aterosclerótica coronariana estável.
OBJECTIVE: To study the prognostic value of exercise stress test variables in elderly patients with coronary atherosclerosis and exercise-induced ischemia. METHODS: Sixty-four elderly patients (61 men, 73 ± 5 years old) with coronary atherosclerosis, verified by cardiac catheterization, that were clinically stable, had a left ventricle ejection fraction greater than or equal to 0.40 and developed myocardial ischemia during the exercise stress test were studied. The patients were evaluated every six months for cardiac events (death, myocardial infarction, unstable angina, angioplasty and myocardial revascularization). RESULTS: After a mean follow-up period of 48 months, 23 (36%) patients suffered cardiac events. There was no clinical or angiographical differences among the patients that suffered cardiac events and those that did not. Using multivariate analysis, the presence of chest pain during the exercise stress test (relative risk 2.668, p = 0.031) and the heart rate at the onset of ischemia (relative risk 0.966, p = 0.009) were associated with cardiac events. CONCLUSION: In this elderly population, the presence of chest pain during the exercise stress test and the heart rate at the onset of ischemia were associated with cardiac events. These variables could be useful for risk evaluation in patients with stable coronary atherosclerosis.
Reference Key
ochiai2006arquivosteste Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Marcelo Eidi Ochiai;Otávio C. E. Gebara;João Batista Serro-Azul;Lígia B. Pinto;Amit Nussbacher;Humberto Pierri;Mauricio Wajngarten
Journal revista cubana de ciencias informáticas
Year 2006
DOI
10.1590/S0066-782X2006000500004
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2006000500004
Keywords
aged coronary disease idoso

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