Key result
Among patients receiving elective PCI for stable CAD, 58.4% received a stress test within 90 days prior to the procedure, with myocardial perfusion imaging being the most commonly used test.
Why the study?
Non-invasive demonstration of ischemia is considered fundamental before elective PCI for stable CAD, but real-world utilization of stress tests in a nationwide cohort required investigation.
What is the utilization rate of stress tests prior to elective PCI for stable CAD in Taiwan?
Cohort (n=3,163)
Yes
What is the utilization rate of stress tests prior to elective PCI for stable CAD in Taiwan?
Almost 60% of patients with stable CAD in Taiwan received stress tests within 90 days prior to elective PCI, with MPI being the most common modality.
Stress testing precedes most elective PCIs for stable CAD; leaves open its impact on appropriateness and outcomes.
BACKGROUND: Ischemia shown in non-invasive tests is considered to be a fundamental requirement for treating patients with stable coronary artery disease (CAD) with a percutaneous coronary intervention (PCI). In a nationwide cohort, we investigated the utilization of stress tests, including myocardial perfusion imaging (MPI), treadmill exercise test (TET) and stress echocardiography (SE) prior to elective PCI. METHODS: This retrospective study used the Longitudinal Health Insurance Database 2000 (LHID2000) of the National Health Insurance program in Taiwan. The LHID2000 is comprised of one million randomly sampled beneficiaries. We enrolled patients receiving elective PCI for stable CAD from 2000 to 2013. Stress tests performed within 90 days prior to PCI and patient characteristics correlated with the utilization of stress tests were investigated. RESULTS: During the investigation period, 3,163 patients received elective PCI for stable CAD and 1,847 (58.4%) patients had at least one stress test within 90 days prior to PCI. Among them, 1,461 (79.1%) had MPI, 1,228 had TET (66.4%) and only 1 had SE (0.05%). Age < 80 years, regional hospital and hyperlipidemia were independently associated with an increased likelihood of receiving stress tests. On the other hand, Charlson-comorbidity index score ≥ 1, prior catheterization and heart failure were independently associated with a decreased likelihood of receiving stress tests. CONCLUSIONS: In the setting of stable CAD, almost 60% of our patients received stress tests within 90 days prior to elective PCI, and MPI was the most commonly used test.
No takes yet. Share an insight, caveat, or question.
Yang et al. (2019) conducted a cohort in Stable coronary artery disease (n=3,163). Stress tests (myocardial perfusion imaging, treadmill exercise test, stress echocardiography) was evaluated on Utilization of stress tests within 90 days prior to PCI. Among patients receiving elective PCI for stable CAD, 58.4% received a stress test within 90 days prior to the procedure, with myocardial perfusion imaging being the most commonly used test.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: