Author + information
- John J. Mahmariana,b,
- Manuel Cerqueiraa,b,
- Tanya Burtona,b,
- Jerry Searea,b,
- Rita Kristya,b,
- Therese Kitta,b and
- James Spaldinga,b
Background: Proper triage of acute chest pain in the emergency department (ED) is critical for optimal outcomes. Myocardial perfusion imaging (MPI) and exercise treadmill testing (ETT) are methods for evaluating patients for ischemia. We compared the outcomes of MPI and ETT patients in a US claims database.
Methods: Adults in the ED receiving MPI or ETT from 1/2012 – 6/2014 were followed for 1 year. Propensity score matching was performed overall and within 3 pre-test ACS risk groups: low, intermediate, and high. Outcomes included: hospitalizations for cardiac events, death and health care costs.
Results: A total of 51,087 patients were identified. Mean age was 56 years and 52% were male. For the high risk group, MPI patients had lower rates of MACE (myocardial infarction, angina, and/or death) and hospitalizations for coronary artery disease and heart failure than ETT patients at 1 year. The intermediate MPI group also showed reduced hospitalizations; but the low MPI group had higher rates of MACE and angiography. Total costs were greater for MPI patients in the low and intermediate groups, but similar to ETT patients in the high risk group.
Conclusions: Evaluation of high risk MPI patients for suspected ischemia in the ED resulted in lower cardiac event rates and equivalent costs. In intermediate MPI patients there was also a trend for lower events, but in low MPI patients there were higher events and costs. Results support MPI over ETT as a first line strategy for evaluating high risk acute chest pain patients in the ED.
Room 140 B
Sunday, March 19, 2017, 9:17 a.m.-9:27 a.m.
Session Title: Highlighted Original Research: Non Invasive Imaging and the Year in Review
Abstract Category: 30. Non Invasive Imaging: Nuclear
Presentation Number: 909-14
- 2017 American College of Cardiology Foundation