title: The timing and impact of follow-up studies after normal stress single-photon emission computed tomography sestamibi studies.
abstract: 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 (ie, time to 1% risk of death or myocardial infarction).
  
  
  RESULTS
  We identified patients at Mayo Clinic Rochester who had normal stress SPECT scans in 2002. Of 2354 patients without prior coronary artery disease, 309 (13%) had routine follow-up scans. The time to routine follow-up was a median of 2.1 years (25th percentile, 1.2 years; 75th 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 revascularization. Of 656 patients with prior coronary artery disease, 171 (26%) had routine follow-up scans. The time to routine follow-up was a median of 1.6 years (25th percentile, 1.0 years; 75th percentile, 2.7 years). This interval was a median of 164% of the warranty period. Of the 171 patients, only 7 (4%) underwent coronary angiography, without revascularization.
  
  
  CONCLUSIONS
  In patients without prior coronary artery disease, routine follow-up SPECT 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 coronary artery disease but generally after the end of the warranty period. Routine follow-up SPECT scans have minimal impact on referral to catheterization or revascularization.
authors.affiliation: Mayo Foundation, Rochester, MN 55902, USA. carryer.damita@mayo.edu
authors.forename: Damita Jo
authors.initials: DJ
authors.lastname: Carryer
authors.forename: J Wells
authors.initials: JW
authors.lastname: Askew
authors.forename: David O
authors.initials: DO
authors.lastname: Hodge
authors.forename: Todd D
authors.initials: TD
authors.lastname: Miller
authors.forename: Raymond J
authors.initials: RJ
authors.lastname: Gibbons
mesh_terms: D000241:Adenosine; D000368:Aged; D016009:Chi-Square Distribution; D019992:Databases as Topic; D018450:Disease Progression; D005080:Exercise Test; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D055414:Myocardial Perfusion Imaging / Q000379:methods* / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011379:Prognosis; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000706:statistics & numerical data; D014665:Vasodilator Agents
chemical_list: D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; D017256:Technetium Tc 99m Sestamibi; D000241:Adenosine