Temporal Trends in Noninvasive and Invasive Cardiac Testing From 2010 to 2022 in the US Medicare Population
Authors' conclusion
Between 2010 and 2022, cardiac diagnostic testing in the US Medicare population shifted from invasive angiography and traditional stress testing toward an increase in cardiac CT, cardiac magnetic resonance, and positron emission tomography. Pyrophosphate scintigraphy studies also increased, as did fractional flow reserve by CT since its introduction. Changes in preferred diagnostic modalities suggest a need to reevaluate current recommendations for training in cardiovascular medicine.
Study context
- Population
- US Medicare Part B population, 2010 to 2022
- Comparison
- Annual cardiac testing volumes compared across tests and by provider specialty
- Outcome
- Transthoracic echocardiography share of cardiac testing use
- Follow-up
- 2011 and 2022
Main finding
As reported in the abstract
2011
61.5%
2022
67.7%
Further findings
Single-photon emission computed tomography (CT) myocardial perfusion imaging share of cardiac testing use
- Decreased from
- 20.8%
- To
- 12.9%
SPECT myocardial perfusion imaging use relative to other modalities · 2011 and 2022
- vs positron emission tomography myocardial perfusion imaging, 2011
- 39:1
- vs positron emission tomography myocardial perfusion imaging, 2022
- 7:1
- vs stress cardiac magnetic resonance, 2011
- 1179:1
- vs stress cardiac magnetic resonance, 2022
- 268:1
- vs coronary CT angiography, 2011
- 61:1
- vs coronary CT angiography, 2022
- 10:1
Decreased use of other tests (share of cardiac testing)
- Exercise treadmill testing
- 2.3% to 1.7%
- Stress echocardiography
- 3.6% to 2.6%
- Multigated acquisition
- 0.4% to 0.1%
- Invasive coronary angiography
- 8.0% to 7.0%
Fractional flow reserve by CT per 100 000 Medicare enrollees · 2018 to 2022
- Increase
- >16-fold
- 2018 the first year covered
Cardiac amyloidosis pyrophosphate scintigraphy studies · 2011 to 2022
- Increase
- 4-fold
- Share
- 0.17% to 0.68%
Projected volume crossovers
- PET myocardial perfusion imaging projected to surpass stress echocardiography
- 2024
- Coronary CT angiography projected to overtake exercise treadmill testing
- 2024
- Coronary CT angiography projected to overtake stress echocardiography
- 2025
- PET myocardial perfusion imaging volumes have surpassed exercise treadmill test volumes
- Assuming the current rate of change continues
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →