Referral physicians' indications for myocardial perfusion scintigraphy

Year 2015, , 130 - 133, 01.05.2015

Billur Çalışkan Ayşe Nurdan Korkmaz

https://doi.org/10.5505/abantmedj.2015.58672

Abstract

OBJECTIVE: We aim to investigate which clinical indications led to referrals for myocardial perfusion scintigraphy MPS METHODS: We retrospectively analyzed patients referred to our department for MPS based on previous history of coronary artery disease CAD , risk factors for CAD, age, and gender. Clinical indications for MPS were sorted into the following five categories: diagnosis of CAD; assessment of the impact of coronary stenosis; viability assessment; preoperative risk assessment of non-cardiac surgery; estimation of treatment effects. RESULTS: 770 patients were included in the study. Most of the patients were referred for MPS for diagnosis of CAD 531 patients, 69% , and most had a low probability of CAD 369 patients, 69.5% . Of the 531 patients, 128 patients had an intermediate probability and 34 patients had high probability of CAD. Other indications for MPS included estimation of treatment effects 24.9% , assessment of the impact of coronary stenosis 3.8% , preoperative risk assessment 1.7% , and viability assessment 0.6% . CONCLUSION: Based on our results, MPS is not used effectively in our region. Most of the indications, including preoperative risk assessment and viability were rarely used. In a high proportion of cases, MPS was used inappropriately to evaluate patients with a low probability of CAD.

Keywords

Myocardial perfusion imaging, coronary disease, risk factors

Myokard perfüzyon sintigrafisi için klinisyenlerin endikasyonları

Abstract

AMAÇ: Bu çalışmada hangi klinik endikasyonlarla hastaların myokard perfüzyon sintigrafisine MPS sevk edildiğini araştırmayı amaçladık. YÖNTEMLER: Bölümümüze MPS için gönderilen hastaları, koroner arter hastalığı KAH öyküsü, KAH için risk faktörleri, yaş ve cinsiyete göre retrospektif olarak inceledik. MPS için endikasyonlar şu şekilde beş kategoriye ayrıldı: KAH tanısı; koroner stenozun etkisinin araştırılması; canlılık tayini; kardiak-dışı cerrahi için cerrahi öncesi risk tayini; tedavi etkinliğinin araştırılması. BULGULAR: 770 hasta çalışmaya dahil edildi. Hastaların çoğunluğu 531 hasta, %69 KAH tanısı için MPS' ye sevkedildi ve bunların çoğunluğu KAH için düşük riskli hastalardı 369 hasta, %69,5 . 531 hastanın 128'i KAH için orta riskli, 34'ü ise yüksek riskli hasta grubundaydı. MPS için diğer endikasyonlar, tedavi etkinliğinin belirlenmesi %24,9 , koroner stenozun etkisinin tayini % 3,8 , cerrahi öncesi risk değerlendirmesi % 1,7 ve canlılık tayini %0,6 idi. SONUÇ: Bulgularımız MPS' nin bölgemizde etkin bir şekilde kullanılmadığını göstermektedir. Cerrahi öncesi risk değerlendirmesi, canlılık ve koroner stenozun fonksiyonelliğinin araştırılmasını içeren birçok endikasyon nadiren kullanılmaktadır. KAH için düşük risk grubundaki hastalar ise uygunsuz olarak MPS'ye gönderilen hastaların çoğunluğunu oluşturmaktadır.

Keywords

Myokard perfüzyon sintigrafisi, koroner arter hastalığı, risk faktörleri

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