title: The impact of modern noninvasive cardiac imaging on coronary intervention rates.
abstract: OBJECTIVE
  It remains still unclear whether the use of modern noninvasive diagnostic modalities for evaluation of coronary artery disease (computed tomography coronary angiography (CTCA), nuclear myocardial perfusion imaging (MPI)) were able to change the "diagnostic yield" of invasive coronary angiography (ICA).
  
  
  METHODS
  The total number of ICA in the years 2000-2009 was related to the number of percutaneous interventions (PCIs) and we assessed whether there was a significant trend over time using time series analyses. We compared these data with the number of patients undergoing CTCA and nuclear MPI in the same time period.
  
  
  RESULTS
  During the 10-year observational period, 23,397 ICA were performed. The proportion of purely diagnostic ICA (without PCI) remained stable over the whole study period (tau = -0.111, P = 0.721). A CTCA program was initiated in 2005 and 1,407 examinations were performed until 2009. Similarly, the number of nuclear MPI increased from 2,284 in the years 2000-2004 to 5,260 in the years 2005-2009 (P = 0.009).
  
  
  CONCLUSIONS
  Despite increasing availability, noninvasive testing modalities did not significantly alter the rate of purely diagnostic ICA, and still are underused as gatekeeper to ICA. Further effort is needed to optimize the use of noninvasive imaging modalities in the work-up process for coronary artery disease.
authors.affiliation: Cardiovascular Center, Cardiology and Cardiac Imaging, Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland; The Heart Hospital London, University College London, London, United Kingdom.
authors.forename: Georg M
authors.initials: GM
authors.lastname: Fröhlich
authors.forename: Boris
authors.initials: B
authors.lastname: Schoch
authors.forename: Mathias
authors.initials: M
authors.lastname: Wolfrum
authors.forename: Martin
authors.initials: M
authors.lastname: Osranek
authors.forename: Frank
authors.initials: F
authors.lastname: Enseleit
authors.forename: Bernhard A
authors.initials: BA
authors.lastname: Herzog
authors.forename: Mathias
authors.initials: M
authors.lastname: Hasun
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.forename: Pascal
authors.initials: P
authors.lastname: Meier
authors.forename: Oliver
authors.initials: O
authors.lastname: Gaemperli
authors.forename: Philipp A
authors.initials: PA
authors.lastname: Kaufmann
authors.forename: Roberto
authors.initials: R
authors.lastname: Corti
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003327:Coronary Disease / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed