Temporal trends of stress myocardial perfusion imaging: Influence of diabetes, gender and coronary artery disease status.
BACKGROUND
Temporal trends of myocardial perfusion imaging (MPI) among diabetics and non-diabetics and the influence of gender and prior coronary artery disease (CAD) status has not been previously investigated.


METHODS
Consecutive patients who underwent clinically indicated stress-MPI over a 17-year period (1996 through 2012) were studied. Data were collected prospectively as a part of the ongoing clinical databases. Study patients were divided into 4 temporal subgroups (1996 to 2000, 2001 to 2004, 2005 to 2008 and 2009 to 2012) to compare the trends of cardiac risk factors and the frequency of abnormal and ischemic MPI.


RESULTS
Of 78,344 total stress MPI studies, 30.2% were in diabetics. The frequency of abnormal MPI studies, while substantially higher in diabetics, significantly declined over time both in diabetics (53.6% in 1996 to 39.8% in 2012) and non-diabetics (37% in 1996 to 27.4% in 2012), despite an increase in the cardiac risk factor profile. Furthermore, among patients with no known CAD, the temporal prevalence of abnormal MPI was highest in diabetic men (57.5% in 1996 to 31.9% in 2012), lowest in non-diabetic women (18.8% in 1996 to 11% in 2012), and both intermediate and comparable in non-diabetic men and diabetic women (36.4% and 35.7% in 1996 and 20.7% and 17.5% in 2012, respectively).


CONCLUSIONS
Despite a temporal reduction in the prevalence of abnormal studies from 1996 through 2012, stress MPI continues to play an important clinical role, particularly in diabetics, men and patients with known-CAD.
Division of Cardiology, Hartford Hospital, Hartford, CT, United States.
Lovely
L
Chhabra
Division of Cardiology, Hartford Hospital, Hartford, CT, United States.
Alan W
AW
Ahlberg
Division of Cardiology, Mount Sinai Medical Center, New York, NY, United States.
Milena J
MJ
Henzlova
Division of Cardiology, Hartford Hospital, Hartford, CT, United States. Electronic address: Lane.Duvall@hhchealth.org.
W Lane
WL
Duvall
D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005080:Exercise Test / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000639:trends*; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors
Coronary artery disease; Diabetes mellitus; Exercise stress; Myocardial perfusion imaging; Pharmacologic stress