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HPC do myocardial perfusion studies performed in the outpatient cummunity setting effectively risk stratify for future coronary events?

15 August 2005


Coronary Heart Disease (CHD) continues to be the leading cause of death in adults, despite an improvement in overall mortality throughout the last three decades1. According to the Framingham Heart Study, the lifetime risk of CHD for individuals at age 40 is 49 percent in men and 32 percent in women1. For total coronary events, the incidence rises steeply with age, with women lagging behind men by 10 years2. For the more serious manifestations of coronary disease, such as myocardial infarction (MI) and sudden death, women lag behind men in incidence by 20 years, but the sex ratio for incidence narrows progressively with advancing age2.

The question that many providers have is: How do we assess the risk of an adverse cardiac event in patients with coronary risk factors and/or suspicious symptoms? It has not been determined what the appropriate method to assess potential risk should be. There are known risk factors that providers can assess, but these risk factors do not provide enough information to assess the presence of CHD in our patients and more precise screening tests need to be performed.

Myocardial perfusion imaging is a type of nuclear study that is frequently used in the community outpatient setting to diagnose myocardial ischemia and to identify areas of infarction. A retrospective study has been conducted by completing a chart review and calling patients for follow-up to determine the incidence of coronary events within one year after having a MPI scan. Our goal is to demonstrate whether patients are being effectively risk stratified in the community outpatient setting with regard to MI and cardiac death.


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