Abstract
To assess the safety of intravenous adenosine myocardial perfusion imaging in the elderly, we compared the outcome of younger and older patients from a cohort of 774 consecutive patients. Adenosine was administered as a 0.14-mg/kg/min constant infusion for 6 min. There were 596 (77%) patients aged ≤ 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 different between the two groups. There was a statistically nonsignificant increase in 2nd- and 3rd-degree atrioventricular block and in the discontinuation rate of adenosine in older patients. This was not associated with a clinically relevant adverse outcome. Other than age, there 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 incidence of atrioventricular block and adenosine discontinuation in the elderly, but it is not associated with a clinically relevant adverse outcome.