Study finds substantial decrease in use of cardiac imaging procedure

March 25, 2014

There has been a sharp decline since 2006 in the use of nuclear myocardial perfusion imaging (MPI; an imaging procedure used to determine areas of the heart with decreased blood flow), a decrease that cannot be explained by an increase in other imaging methods, according to a study in the March 26 issue of JAMA.

Nuclear accounted for much of the rapid growth in cardiac imaging that occurred from the 1990s through the middle 2000s. Edward J. McNulty, M.D., of Kaiser Permanente Medical Center, San Francisco, and colleagues conducted a study to examine trends in MPI use within a large, community-based population. They obtained patient data for MPI performed from 2000-2011 for members ages 30 years or older from the clinical databases of Kaiser Permanente Northern California, an integrated health care delivery system that provides inpatient and outpatient care for more than 2.3 million adults.

Overall, MPI was used for 302,506 patients at 19 facilities. From 2000 until 2006, MPI use increased by a relative 41 percent. Then between 2006 and 2011, MPI use declined a relative 51 percent. Declines from 2006 to 2011 were greater for outpatients than inpatients (58 percent vs 31 percent) and for persons younger than 65 years. Use of (a newer imaging procedure) increased during this time period, and could have accounted for 5 percent of the observed decline in overall MPI use if performed as a substitute.

"Although the abrupt nature of the decline suggests changing physician behavior played a major role, incident coronary disease, as assessed by [heart attack], also declined [by 27 percent]. We could not determine the relative effects of these factors on MPI use," the authors write.

"… the substantial reduction in MPI use demonstrates the ability to reduce testing on a large scale with anticipated reductions in ."

Explore further: Blood-based genomic test better than imaging test for ruling out obstructive coronary artery disease

More information: DOI: 10.1001/jama.2014.472

Related Stories

Blood-based genomic test better than imaging test for ruling out obstructive coronary artery disease

November 15, 2011
A blood-based gene expression test was found to be more effective for ruling out obstructive coronary artery disease in stable symptomatic patients than myocardial perfusion imaging (MPI), a common test that uses a radioactive ...

Metabolic PET imaging provides earlier warning of coronary disease

June 11, 2013
Coronary artery disease (CAD) is one of the world's most prevalent and silent killers. Positron emission tomography (PET), which images miniscule abnormalities in cellular metabolism, can tip off clinicians about cardiac ...

Researchers find common test may be unnecessary for bariatric surgery candidates

July 19, 2011
A new study by researchers from Rhode Island Hospital has found that stress testing with myocardial perfusion imaging as part of a pre-operative workup for bariatric surgery candidates may be unnecessary. The research is ...

When less is more: New protocol limits use of SPECT MPI

May 5, 2013
A new stress test protocol that investigates reducing the use of perfusion imaging in low risk patients undergoing SPECT myocardial perfusion imaging for possible angina symptoms was found to be diagnostically safe, revealed ...

CT angiography and perfusion to assess coronary artery disease: The CORE320 study

August 28, 2012
A non-invasive imaging strategy which integrates non-invasive CT angiography (CTA) and CT myocardial perfusion imaging (CTP) has robust diagnostic accuracy for identifying patients with flow-limiting coronary artery disease ...

Recommended for you

Could aggressive blood pressure treatments lead to kidney damage?

July 18, 2017
Aggressive combination treatments for high blood pressure that are intended to protect the kidneys may actually be damaging the organs, new research from the University of Virginia School of Medicine suggests.

Quantifying effectiveness of treatment for irregular heartbeat

July 17, 2017
In a small proof-of-concept study, researchers at Johns Hopkins report a complex mathematical method to measure electrical communications within the heart can successfully predict the effectiveness of catheter ablation, the ...

Concerns over side effects of statins stopping stroke survivors taking medication

July 17, 2017
Negative media coverage of the side effects associated with taking statins, and patients' own experiences of taking the drugs, are among the reasons cited by stroke survivors and their carers for stopping taking potentially ...

Study discovers anticoagulant drugs are being prescribed against safety advice

July 17, 2017
A study by researchers at the University of Birmingham has shown that GPs are prescribing anticoagulants to patients with an irregular heartbeat against official safety advice.

Protein may protect against heart attack

July 14, 2017
DDK3 could be used as a new therapy to stop the build-up of fatty material inside the arteries

Heart study finds faulty link between biomarkers and clinical outcomes

July 14, 2017
Surrogate endpoints (biomarkers), which are routinely used in clinical research to test new drugs, should not be trusted as the ultimate measure to approve new health interventions in cardiovascular medicine, according to ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.