Temporal trends of abnormal myocardial perfusion imaging in a cohort of Italian subjects: Relation with cardiovascular risk factors

Background. The frequency of abnormal stress single-photon emission computed tomographymyocardial perfusion imaging (MPS) has decreased over the past decades despite anincrease in the prevalence of cardiovascular risk factors. This study evaluated the temporaltrend of abnormal stress MPS and its relationship with risk factors in a cohort of Italiansubjects.Methods. We included all patients who underwent clinically indicated stress MPS at ouracademic center between January 2006 and December 2017. Patients were assessed for changein demographics, clinical symptoms, risk factors, and frequency of abnormal and ischemicMPS.Results. A total of 8,886 stress MPS studies were performed (3,350 abnormal). Age,male gender, diabetes, smoking, and angina were independent predictors of abnormal MPS.There was a slight decline in the frequency of abnormal (from 39 to 36%, P < 0.05) andischemic (from 25 to 22%, P < 0.01) MPS during the study period, while the percentage ofpatients with hypertension, hypercholesterolemia, smoking, and angina increased. TheCochran-Mantel-Haenszel test indicates that the likelihood of having an abnormal MPS didnot change over time for age, diabetes, smoking, and a history of coronary artery disease(CAD), increased for hypertension and hypercholesterolemia and decreased for male comparedto female gender.Conclusions. In our cohort of Italian subjects, there was a slight temporal decline in thefrequency of abnormal and ischemic MPS despite an increase over time in the prevalence ofmany cardiac risk factors. These results strengthen the need to develop more effectivestrategies for appropriately referring patients to cardiac imaging procedures. (J NuclCardiol 2019)