Clinical characteristics and referral pattern of patients with left ventricular dysfunction and significant coronary artery disease undergoing radionuclide imaging.
Publication/Presentation Date
1-1-2004
Abstract
BACKGROUND: Many observational studies that predict patient outcomes have examined the use of myocardial perfusion imaging results. However, a referral pattern for radionuclide testing could bias these analyses and should be determined. These patients may also differ with regard to the extent of coronary artery disease (CAD). All of these differences must be incorporated into proper outcomes examinations. We sought to identify the nuclear perfusion imaging referral pattern for patients with left ventricular (LV) dysfunction and significant CAD.
METHODS AND RESULTS: Patients with LV dysfunction and CAD (n = 2951) meeting our inclusion criteria were compared by receipt or absence of radionuclide perfusion testing within 6 months before or after angiography. Pearson chi2 and Kruskal-Wallis analyses were used to examine differences in baseline characteristics and catheterization results, whereas logistic regression modeling was applied to predict nuclear imaging referral before and after catheterization. Precatheterization nuclear cohort patients were more likely to be minority patients (odds ratio [OR], 1.34; P =.0083) with previous cardiac revascularization (OR, 2.27; P =.0001), Charlson comorbidity index greater than 1 (OR, 1.146; P =.0091), and heart failure symptoms (OR, 1.62; P =.0001) than those without imaging. They were less likely to have a myocardial infarction (OR, 0.464; P =.0001). After catheterization, the nuclear patients were more likely to have had congestive heart failure (OR, 1.452; P =.0019), a myocardial infarction (OR, 1.353; P =.0371), an ejection fraction lower than 30% (OR, 1.058; P =.0002), and prior revascularization (OR, 1.880; P =.0001). In addition, they had fewer diseased vessels (OR, 0.731; P =.0001).
CONCLUSIONS: Bias exists in nuclear referral for patients with LV dysfunction and significant CAD and must be considered when interpreting observational studies on this topic.
Volume
11
Issue
2
First Page
118
Last Page
125
ISSN
1071-3581
Published In/Presented At
Bourque, J. M., Velazquez, E. J., Borges-Neto, S., Shaw, L. K., Whellan, D. J., & O'connor, C. M. (2004). Clinical characteristics and referral pattern of patients with left ventricular dysfunction and significant coronary artery disease undergoing radionuclide imaging. Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 11(2), 118–125. https://doi.org/10.1016/j.nuclcard.2003.09.005
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
15052242
Department(s)
Research, Administration and Leadership
Document Type
Article