Ho-Pang Yang1, Guang-Uei Hung2, Cheng-Li Lin3,4, Thau-Yun Shen1, Chien-Cheng Chen1, Ya-Lei Niu5, Chia-Hung Kao6,7. 1. Department of Cardiology, Show Chwan Memorial Hospital. 2. Department of Nuclear Medicine, Chang-Bing Show Chwan Memorial Hospital, Changhua. 3. Management Office for Health Data, China Medical University Hospital. 4. College of Medicine, China Medical University, Taichung. 5. Department of Cardiology, Chang-Bing Show Chwan Memorial Hospital, Changhua. 6. Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University. 7. Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
Abstract
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.
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.
Authors: L J Shaw; R Hachamovitch; D S Berman; T H Marwick; M S Lauer; G V Heller; A E Iskandrian; K L Kesler; M I Travin; H C Lewin; R C Hendel; S Borges-Neto; D D Miller Journal: J Am Coll Cardiol Date: 1999-03 Impact factor: 24.094
Authors: D Wennberg; J Dickens; D Soule; M Kellett; D Malenka; J Robb; T Ryan; W Bradley; P Vaitkus; M Hearne; G O'Connor; R Hillman Journal: J Health Serv Res Policy Date: 1997-04
Authors: Sidney C Smith; Ted E Feldman; John W Hirshfeld; Alice K Jacobs; Morton J Kern; Spencer B King; Douglass A Morrison; William W O'Neil; Hartzell V Schaff; Patrick L Whitlow; David O Williams; Elliott M Antman; Cynthia D Adams; Jeffrey L Anderson; David P Faxon; Valentin Fuster; Jonathan L Halperin; Loren F Hiratzka; Sharon Ann Hunt; Rick Nishimura; Joseph P Ornato; Richard L Page; Barbara Riegel Journal: Circulation Date: 2006-02-21 Impact factor: 29.690
Authors: William E Boden; Robert A O'Rourke; Koon K Teo; Pamela M Hartigan; David J Maron; William J Kostuk; Merril Knudtson; Marcin Dada; Paul Casperson; Crystal L Harris; Bernard R Chaitman; Leslee Shaw; Gilbert Gosselin; Shah Nawaz; Lawrence M Title; Gerald Gau; Alvin S Blaustein; David C Booth; Eric R Bates; John A Spertus; Daniel S Berman; G B John Mancini; William S Weintraub Journal: N Engl J Med Date: 2007-03-26 Impact factor: 91.245
Authors: H Vernon Anderson; Richard E Shaw; Ralph G Brindis; Lloyd W Klein; Charles R McKay; Michael A Kutcher; Ronald J Krone; Michael J Wolk; Sidney C Smith; William S Weintraub Journal: Circulation Date: 2005-11-01 Impact factor: 29.690
Authors: Grace A Lin; R Adams Dudley; F L Lucas; David J Malenka; Eric Vittinghoff; Rita F Redberg Journal: JAMA Date: 2008-10-15 Impact factor: 56.272