[Exercise stress test: prognostic value for elderly patients with stable coronary atherosclerosis].

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.