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A multicenter evaluation of the appropriate use of single-photon emission tomography myocardial perfusion imaging in Greece.
MedLine Citation:
PMID:  23430360     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: This study evaluates the appropriate use of myocardial perfusion imaging (MPI) and determines patterns and variables associated with inappropriate testing. METHODS: Over a 10-month period data were collected prospectively from consecutive patients referred for MPI in four academic departments and an appropriate use grade was assigned (appropriate, uncertain, inappropriate, and unclassifiable scans) according to established criteria. RESULTS: Among 3,032 referrals appropriate MPI had 72.8% of patients and 19.2% of studies were inappropriate, the remaining being uncertain (7.2%) or unclassifiable (0.8%). In multivariate analysis the asymptomatic status (odds ratio 10.7, P < .001), good functional capacity (odds ratio 1.9, P < .001), an interpretable resting electrocardiogram (odds ratio 1.8, P = .004), an age <65 years (odds ratio 1.5, P = .001) and the absence of diabetes (odds ratio 1.7, P < .001) or dyslipidemia (odds ratio 1.3, P = .014) were independent predictors of inappropriate scintigraphy. The most common indication for inappropriate testing was the assessment of asymptomatic patients <2 years after percutaneous coronary intervention (PCI) (38.9%). CONCLUSIONS: The appropriate use of MPI is relatively high, but a considerable proportion of inappropriate scans is noted which is associated with markers of lower risk. The most common source of inappropriate testing is the assessment of asymptomatic patients <2 years after PCI.
Authors:
Efstratios Moralidis; Nafsika Papadimitriou; Maria Stathaki; Xanthi Xourgia; Tryfon Spyridonidis; Andreas Fotopoulos; Dimitrios Apostolopoulos; Nikolaos Karkavitsas; Anna Gotzamani-Psarrakou
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-21
Journal Detail:
Title:  Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology     Volume:  -     ISSN:  1532-6551     ISO Abbreviation:  J Nucl Cardiol     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423534     Medline TA:  J Nucl Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Nuclear Medicine, AHEPA University Hospital, Aristotle University Medical School, 1 Stilponos Kyriakidi Str, 54636, Thessaloníki, Greece, emoral@hol.gr.
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