Coronary disease & ACSCohort study
Temporal trends in pretest probability and normal scan rates in myocardial perfusion imaging: a 24-year experience from a Swiss tertiary referral center (between 2000 and 2024)
- retrospective study
Authors' conclusion
The rate of normal MPI results increased over time, but the trend was less pronounced than previously published. Possible explanations include referral of healthier patients (unchanged CACS despite increasing age), less typical angina, a lower prevalence of established CAD, and more female patients.
Study context
- Population
- Patients undergoing myocardial perfusion imaging at a large Swiss centreMyocardial perfusion imaging (MPI) scans analysed
- Participants
- 45,686 patients
- Exposure
- Temporal trends in pre-test probability and MPI findings over time
Main finding
As reported in the abstract
Normal MPI results increased significantly over time, 2000
53%
Normal MPI results, 2024
66%
Observational data: associations, not effects.
Further findings
Small ischaemia (Summed Difference Score ≥2)
- Small ischaemia decreased
- 37.6% → 34.2%
- P < 0.001
Relevant ischaemia (≥10% ischaemia)
- Relevant ischaemia increased slightly
- 11.0% → 13.2%
- P < 0.001
SSS, SRS and SDS
- SSS and SRS decreased significantly, whereas SDS remained unchanged
Coronary artery calcium score (CACS) and prevalence of zero CACS
- CACS and the prevalence of zero CACS remained unchanged over time
Performance of ESC pre-test probability (PTP) models and RF-CL
- ESC PTP models overestimated the prevalence of abnormal MPI and small ischaemia
- Only RF-CL predicted relevant ischaemia correctly in very low-risk patients
Original publication
Summarised from the published abstract; every number is checked against it