Evaluation of the Appropriateness of Patients Referring for Single-Photon Emission Tomography Myocardial Perfusion Imaging Based On ACCF/ASNC AUC 2009

Authors: Abedi SM, Farsavian A, Golshani S, Cherati JY, Mojaveri SG and Mardanshahi A*

DOI: 10.23880/ijnmrs-16000126

Volume 3, Issue 1

Abstract

Introduction: Coronary artery disease causes one third of all mortality per year throughout the world. In patient with suspicions coronary artery disease many diagnostic imaging procedure obtained. ACCF/ASNC AUC2009 was developed as a guide in cardiology for evaluation of patient with cardiovascular disease. The aim of this study is the evaluation of appropriateness of patient referring to our nuclear medicine center according to the AUC-2009 lastly published by ACCF/ASNC. Methods: All patients that referred to our center from 2017/02/03 to 2017/06/15 enrolled in this study. Based on the AUC- 2009 criteria, patients were classified as appropriate, inappropriate, uncertain and unclassified. Then the prevalence of each groups determined and the correlation with sex, age and myocardial perfusion scintigraphy results were evaluated. Results: 875 patients were enrolled in this study. The mean age was 58.6±12 years and 58.9% of all patients were female. Stress phase of MPI was performed with exercise test in 132 (15.3%), dipyridamole stress test in 716 (83.1%) and dobutamine stress test in 13 (1.4%) of the patients. In 500 (57.1%) of patients the results of MPI was abnormal. From all patients 72 individuals (8.2%) referred for myocardial viability evaluation, 76(8.6%) had history of previous CABG, 77(8.8%) had previous history of PTCA and 36(4.1%) referred for preoperative evaluation of non-cardiac surgery. From all patients, 696(79.5%) patients were found as “appropriate”, 165 (18.9%) as “inappropriate”, 8 (0.9%) as “uncertain” and 6(0.7%) patients as unclassified based on ACCF/ASNM AUC 2009 criteria. Conclusion: This study revealed the referring patients for MPI in our academic center are closely correlated to the ACCF/ ASNM AUC 2009 criteria. The probability of abnormal MPI result was significantly greater in appropriate group than other groups. No statistically significant difference was observed in age and gender among the groups. The most probable cause of referring for MPI in appropriate group was inability to perform exercise test (61%) and the most probable cause of patient classified as inappropriate was ability to performing exercise test (45.5%).

Keywords: Myocardial Perfusion Imaging; Cardiovascular Disease; Appropriate Use Criteria

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