The Particulars: Previous studies indicate that achieving 10 metabolic equivalents of task (METS) of exercise workload during exercise single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) is associated with low risk of significant ischemia and subsequent cardiac events. Whether this association exists in older patients has yet to be determined.

Data Breakdown: Study investigators blindly interpreted SPECT MPI scans for patients without known coronary artery disease (CAD) who achieved 10-METS of exercise workload during exercise SPECT MPI. When data for participants aged 65 and older was compared with data for those younger than 65, the prevalence of ischemia was not significantly different (4.7% vs 2.6%). Both groups had a low prevalence of significant left ventricular ischemia. Neither group experienced a cardiac death or non-fatal myocardial infarction.

Take Home Pearls: The prevalence of ischemia, cardiac events, or significant left ventricular ischemia does not appear to be affected by age among patients without known CAD who achieve 10-METS of exercise workload during exercise SPECT MPI. Study authors suggest there is no compelling reason for mandating imaging in this older patient population.