The results of 3 years registry on myocardial perfusion imaging, do we use the appropriateness criteria as expected?

Document Type : Original Article

Authors

1 Cardiology department, faculty of Medicine ,Ain shams university

2 Armed Force Hospitals

Abstract

Background

The progress in nuclear myocardial perfusion imaging (MPI) is associated with widespread concern regarding imaging utilization ,increased healthcare costs. There is no comparative data that guide the use of these modalities with respect to appropriateness and patients’ benefit. So,we aimed to explore the extent to which MPI studies met published appropriate use criteria (AUC).

Methods

Three years registery that included 2598 patients who underwent MPI in Ain Shams university nuclear cardiology unit throughout the period from January 2017 to December 2019.Calculation of pretest probability and Framingham risk score, determination of appropriateness use criteria were implented

Results

The study included 2598 patients with mean age of 57.76 years, with male predominance (68.1%), 38.2% were diabetics and 53% had hypertension. The most common indications to undergo MPI was the exclusion of CAD as a cause of chest pain in 38.8% of patients followed by the evaluation of symptomatic post PCI patients in 21.9%. Moreover 63.8% of patients showed appropriate tests, while 18.6% of patients showed uncertain tests ,whereas 17.6% of patients had inappropriate studies.Moreover,81% of appropriate tests showed positive MPI results. Whereas in the inappropriate and the uncertain category, the negative test for ischemia predominated.



Conclusions

we concluded that in our unit the appropriate tests were more prominent than inappropriate and unclassified tests. Most of the appropriate studies were positive for ischemia. While, most of the inappropriate and uncertain tests were normal and the commonest cause of referral for MPI was exclusion of CAD as a cause of chest pain.

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