Temporal trends in stress Myocardial Perfusion Imaging (MPI) studies in patients with Coronary Artery Disease (CAD) and with no CAD among Saudi Arabian’s population

• Main Authors: Mohamed Ebid, Amjad M. Ahmed, Fatmah T. Almasoudi, Mousa Alfaris, Ihab Suliman, Henery Fielding, Misfer Aldosari
• Format: Article
• Language: English
• Published: Saudi Heart Association 2018-10-01
• Series: Journal of the Saudi Heart Association
• Online Access: http://www.sciencedirect.com/science/article/pii/S1016731518301696

Introduction: Previous studies showed that lower risk patients are being referred to stress testing. Few studies suggested that the frequency of abnormal myocardial perfusion imaging (MPI) studies have declined over the past two decades to even less than 10%. However, it is not clear if this is a universal observation. The aim of this analysis is to assess the temporal trends of the prevalence of abnormal and ischemic MPI studies among large consecutive cohort of Saudi Arabia’s population over a period of 11 years. Methodology: From a high volume single center registry, we assessed all patients who undergone stress MPI studies between Octobers 2007 to June 2017 for changes in their demographics, baseline clinical information, past cardiac history, and cardiac risk factors. We also compared the trends of the frequency of abnormal and ischemic MPI. The sample was divided into 5 successive temporal subgroups for the purposes of analysis: 2007 to 2008; 2009 to 2010; 2011 to 2012; 2013 to 2014; and 2015 to 2017. Results: A total of 13,786 MPI studies were analysed over the specified duration. There was a progressive decline in the prevalence of abnormal MPI in all patients, from 50.8% in 2007 to 32.3% in 2017, (P < 0.0001). Correspondingly, the prevalence of ischemic MPI declined, from 40.1% to 22.1%, (P < 0.0001). Also, there was an increase in the percentage of older patients’ ⩾65 years (40.9%). The overall rate of abnormal MPI was 41.0%, (28.2% in patients with no known coronary artery disease (CAD) and 67.6% in patients with known CAD) and both rates were declining over time. Conclusion: There has been a temporal decline in the prevalence of abnormal and ischemic MPI studies over a period of 11 years. However, this decline is significantly lower than the previously reported from western cohorts.