SAFETY AND DIAGNOSTIC-ACCURACY OF ADENOSINE-THALLIUM IMAGING IN THE ELDERLY

To assess the safety of intravenous adenosine myocardial perfusion ima ging in the elderly, we compared the outcome of younger and older pati ents from a cohort of 774 consecutive patients. Adenosine was administ ered as a 0.14mg/kg/min constant infusion for 6 min. There were 596 (7 7%) patients aged less than or equal to 70 years (group 1) and 178 (23 %) patients aged >70 years (group 2). The incidence of noncardiac side effects (such as flushing, headache, etc.) and cardiac side effects ( such as chest pain, ST segment depression, and hypotension) was not di fferent between the two groups. There was a statistically nonsignifica nt increase in 2nd- and 3rd-degree atrioventricular block and in the d iscontinuation rate of adenosine in older patients. This was not assoc iated with a clinically relevant adverse outcome. Other than age, ther e were no other variables predictive of differences in adverse outcome . The use of adenosine for myocardial perfusion imaging is as safe in younger patients as it is in older patients. There is a higher inciden ce of atrioventricular block and adenosine discontinuation in the elde rly, but it is not associated with a clinically relevant adverse outco me.