Diagnostic value of XXXX severity at myocardial perfusion imaging in elderly @entity1 with suspected coronary disease.

@entity1 @entity296 @entity63 @entity400 @entity741 @entity453
AIMS: Myocardial perfusion and @entity63 scores obtained from @entity296 ( @entity296 ) have strong independent prognostic value in elderly individuals without known @entity453 ( @entity453 ). Herein we aimed to assess their independent diagnostic value and accuracy for @entity453 while considering different thresholds of @entity741 . METHODS: We estimated the @entity400 ( @entity400 ), summed stress score (SSS) and summed difference score (SDS) in 322 elderly individuals (mean age 72  7 years, 68% @entity1 ) who underwent coronary angiography following an @entity296 . Abnormal perfusion at stress was defined as an SSS greater than 3, and @entity63 as an SDS of at least 2, and further categorized as mild (2-4), moderate (5-7) or severe (>7). Multivariate logistic regressions were used to establish the independent diagnostic value and accuracy of @entity296 parameters. RESULTS: @entity453 was diagnosed in 182 individuals (56%). In multivariate analysis accounting for clinical variables associated with @entity453 including the Framingham risk score, both @entity400 [odds ratio (OR) 1.09, 95% confidence interval (CI) 1.01-1.18, P=0.03] and SSS (OR 1.10, 95% CI 1.04-1.16, P=0.0006) and SDS (OR 1.12, 95% CI 1.04-1.21, P=0.003) were independently associated with @entity453 . An SSS greater than 3 was also independently associated with @entity453 (OR 2.51, 95% CI 1.43-4.39, P=0.0013), whereas an SDS of 2 or greater was not (OR 1.62, 95% CI 0.89-2.93, P=0.12), but only when at least 5 (OR 2.31, 95% CI 1.32-4.03, P=0.003). The probability of @entity453 was proportional to the amount of @entity741 in those with an SSS greater than 3, and lower and comparable in those with an SSS of at least 3 or an SSS greater than 3 with SDS of 1 or less (P=0.19). Increasing the threshold of @entity741 determined a decrease in sensitivity and increase in specificity of @entity296 for both diagnosis and severity of @entity453 . CONCLUSION: We established the diagnostic value and accuracy of continuous scores and thresholds of abnormal myocardial perfusion and @entity63 previously validated in prognostic studies. Their more widespread use could potentially improve the diagnostic yield of coronary angiography in elderly individuals with suspected @entity453 .
