The Timing and Impact of Follow-Up Studies After Normal Stress SPECT Sestamibi Studies.
Circ Cardiovasc Imaging. 2010 Jul 14;
Authors: Carryer DJ, Askew JW, Hodge DO, Miller TD, Gibbons RJ
BACKGROUND: -The purpose of this study was to determine the prevalence and timing of routine follow-up single photon emission computed tomography (SPECT) studies after a normal stress SPECT scan compared with the patient's "warranty period" (time to 1% risk of death or [MI]). METHODS AND RESULTS: -We identified patients at Mayo Clinic Rochester who had normal stress SPECT scans in 2002. Of 2,354 patients without prior coronary artery disease (CAD), 309 patients (13% of the patients without prior CAD) had routine follow-up scans. The time to routine follow-up scan was a median of 2.1 years (25(th) percentile, 1.2 years; 75(th) percentile, 3.6 years). This interval was a median of 45% of the "warranty period". Of the 309 patients, only 9 (3%) underwent subsequent coronary angiography, without any revascularization. Of 656 patients with prior CAD, 171 patients (26% of the patients with prior CAD) had routine follow-up scans. The time to routine follow-up scan was a median of 1.6 years (25(th) percentile, 1.0 years; 75(th) percentile, 2.7 years). The time to routine follow-up was a median of 164% of the "warranty period". Of the 171 patients, only 7 (4%) underwent coronary angiography, without any revascularization. CONCLUSIONS: -In patients without prior CAD, routine follow-up scans are performed infrequently, but well before the end of the patient's "warranty period." Routine follow-up scans are performed more commonly in patients with prior CAD, but generally after the end of the patient's "warranty period". Routine follow-up scans have minimal impact on referral to catheterization or revascularization.
PMID: 20631033 [PubMed - as supplied by publisher]