Among non-emergency patients undergoing elective diagnostic coronary angiography, 37.5% did not receive any non-invasive ischemia testing prior to the procedure.
Cross-Sectional (n=2,714)
What is the proportion and what are the predictors of patients not receiving non-invasive ischemia testing prior to elective purely diagnostic coronary angiography?
A substantial proportion of patients (37.5%) undergo elective diagnostic coronary angiography without prior non-invasive ischemia testing, highlighting a significant gap in guideline adherence and potential overuse of invasive procedures.
BACKGROUND: Adequate application of guidelines concerning non-invasive ischemia testing (NIIT) could avoid inappropriate invasive testing in non-emergency situations. Hardly any data exists regarding frequency and appropriateness of diagnostic coronary angiography (CA). The aim of this study was to evaluate the proportion and predictors of patients without NIIT prior to elective purely diagnostic CA without therapeutic intervention. METHODS: Retrospective cross-sectional analysis of insurance claims data from 2012 and 2013. Patients 6 chronic comorbidities were independently associated with a lower proportion of NIIT (p<0.0001, OR 0.607 and p = 0.0041, OR 0.648), when additionally controlled for age, sex, language area, insurance coverage, inpatient treatment, cardiovascular medication and lower number of chronic comorbidities. Age (p<0.05, OR 1.009) and intake of oral antiplatelet therapy (p<0.0001, OR 1.914) were independently associated with a higher proportion of NIIT when controlled for the mentioned cofactors. CONCLUSIONS: Our data show that despite the existence of guidelines a substantial overuse of a potentially harmful and inappropriate diagnostic intervention is performed suggesting the need for improvement of diagnostic pathways prior to invasive testing.
Chmiel et al. (Thu,) conducted a cross-sectional in Suspected coronary heart disease undergoing elective diagnostic coronary angiography (n=2,714). Non-invasive ischemia testing (NIIT) vs. No NIIT was evaluated on Proportion of patients not receiving non-invasive ischemia testing (NIIT) before diagnostic coronary angiography. Among non-emergency patients undergoing elective diagnostic coronary angiography, 37.5% did not receive any non-invasive ischemia testing prior to the procedure.