Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy.
Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy.
J Nucl Cardiol. 2020 Dec;27(6):2167-2177. doi: 10.1007/s12350-019-01630-1. Epub 2019 Feb 7.
The frequency of abnormal stress single-photon emission computed tomography myocardial perfusion imaging (MPS) has decreased over the past decades despite an increase in the prevalence of cardiovascular risk factors. This study evaluated the temporal trend of abnormal stress MPS and its relationship with risk factors in a cohort of Italian subjects.
We included all patients who underwent clinically indicated stress MPS at our academic center between January 2006 and December 2017. Patients were assessed for change in demographics, clinical symptoms, risk factors, and frequency of abnormal and ischemic MPS.
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) and ischemic (from 25 to 22%, P < 0.01) MPS during the study period, while the percentage of patients with hypertension, hypercholesterolemia, smoking, and angina increased. The Cochran-Mantel-Haenszel test indicates that the likelihood of having an abnormal MPS did not change over time for age, diabetes, smoking, and a history of coronary artery disease (CAD), increased for hypertension and hypercholesterolemia and decreased for male compared to female gender.
In our cohort of Italian subjects, there was a slight temporal decline in the frequency of abnormal and ischemic MPS despite an increase over time in the prevalence of many cardiac risk factors. These results strengthen the need to develop more effective strategies for appropriately referring patients to cardiac imaging procedures.
尽管心血管危险因素的患病率增加，但过去几十年来，异常应激单光子发射计算机断层心肌灌注成像（MPS）的频率有所下降。本研究评估了意大利患者队列中异常应激 MPS 的时间趋势及其与危险因素的关系。
我们纳入了 2006 年 1 月至 2017 年 12 月期间在我们学术中心进行临床指征性应激 MPS 的所有患者。对患者的人口统计学数据、临床症状、危险因素以及异常和缺血性 MPS 的频率进行评估。
共进行了 8886 次应激 MPS 研究（3350 次异常）。年龄、男性、糖尿病、吸烟和心绞痛是异常 MPS 的独立预测因素。在研究期间，异常（从 39%降至 36%，P<0.05）和缺血性（从 25%降至 22%，P<0.01）MPS 的频率略有下降，而高血压、高胆固醇血症、吸烟和心绞痛患者的比例增加。Cochran-Mantel-Haenszel 检验表明，年龄、糖尿病、吸烟和冠心病病史的患者发生异常 MPS 的可能性在时间上没有变化，而高血压和高胆固醇血症的可能性增加，与女性相比，男性的可能性降低。
在我们的意大利患者队列中，尽管许多心脏危险因素的患病率随时间增加，但异常和缺血性 MPS 的频率略有下降。这些结果强化了需要制定更有效的策略，以便适当地将患者转介至心脏成像程序。
