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Negative predictive value and potential cost savings of acute nuclear myocardial perfusion imaging in low risk patients with suspected acute coronary syndrome : A prospective single blinded study

Forberg, Jakob L. LU ; Hilmersson, Catarina E. LU ; Carlsson, Marcus LU ; Arheden, Håkan LU ; Björk, Jonas LU ; Hjalte, Krister LU and Ekelund, Ulf LU orcid (2009) In BMC Emergency Medicine 9(12).
Abstract

Background: Previous studies from the USA have shown that acute nuclear myocardial perfusion imaging (MPI) in low risk emergency department (ED) patients with suspected acute coronary syndrome (ACS) can be of clinical value. The aim of this study was to evaluate the utility and hospital economics of acute MPI in Swedish ED patients with suspected ACS. Methods: We included 40 patients (mean age 55 ± 2 years, 50% women) who were admitted from the ED at Lund University Hospital for chest pain suspicious of ACS, and who had a normal or non-ischemic ECG and no previous myocardial infarction. All patients underwent MPI from the ED, and the results were analyzed only after patient discharge. The current diagnostic practice of admitting the... (More)

Background: Previous studies from the USA have shown that acute nuclear myocardial perfusion imaging (MPI) in low risk emergency department (ED) patients with suspected acute coronary syndrome (ACS) can be of clinical value. The aim of this study was to evaluate the utility and hospital economics of acute MPI in Swedish ED patients with suspected ACS. Methods: We included 40 patients (mean age 55 ± 2 years, 50% women) who were admitted from the ED at Lund University Hospital for chest pain suspicious of ACS, and who had a normal or non-ischemic ECG and no previous myocardial infarction. All patients underwent MPI from the ED, and the results were analyzed only after patient discharge. The current diagnostic practice of admitting the included patients for observation and further evaluation was compared to a theoretical "MPI strategy", where patients with a normal MPI test would have been discharged home from the ED. Results: Twenty-seven patients had normal MPI results, and none of them had ACS. MPI thus had a negative predictive value for ACS of 100%. With the MPI strategy, 2/3 of the patients would thus have been discharged from the ED, resulting in a reduction of total hospital cost by some 270 EUR and of bed occupancy by 0.8 days per investigated patient. Conclusion: Our findings in a Swedish ED support the results of larger American trials that acute MPI has the potential to safely reduce the number of admissions and decrease overall costs for low-risk ED patients with suspected ACS.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Emergency Medicine
volume
9
issue
12
article number
12
publisher
BioMed Central (BMC)
external identifiers
  • pmid:19545365
  • scopus:67651015647
ISSN
1471-227X
DOI
10.1186/1471-227X-9-12
language
English
LU publication?
yes
id
401b5456-3216-4de8-bd2a-2c67bf2e993c
date added to LUP
2019-05-14 14:39:52
date last changed
2021-11-17 08:57:17
@article{401b5456-3216-4de8-bd2a-2c67bf2e993c,
  abstract     = {<p>Background: Previous studies from the USA have shown that acute nuclear myocardial perfusion imaging (MPI) in low risk emergency department (ED) patients with suspected acute coronary syndrome (ACS) can be of clinical value. The aim of this study was to evaluate the utility and hospital economics of acute MPI in Swedish ED patients with suspected ACS. Methods: We included 40 patients (mean age 55 ± 2 years, 50% women) who were admitted from the ED at Lund University Hospital for chest pain suspicious of ACS, and who had a normal or non-ischemic ECG and no previous myocardial infarction. All patients underwent MPI from the ED, and the results were analyzed only after patient discharge. The current diagnostic practice of admitting the included patients for observation and further evaluation was compared to a theoretical "MPI strategy", where patients with a normal MPI test would have been discharged home from the ED. Results: Twenty-seven patients had normal MPI results, and none of them had ACS. MPI thus had a negative predictive value for ACS of 100%. With the MPI strategy, 2/3 of the patients would thus have been discharged from the ED, resulting in a reduction of total hospital cost by some 270 EUR and of bed occupancy by 0.8 days per investigated patient. Conclusion: Our findings in a Swedish ED support the results of larger American trials that acute MPI has the potential to safely reduce the number of admissions and decrease overall costs for low-risk ED patients with suspected ACS.</p>},
  author       = {Forberg, Jakob L. and Hilmersson, Catarina E. and Carlsson, Marcus and Arheden, Håkan and Björk, Jonas and Hjalte, Krister and Ekelund, Ulf},
  issn         = {1471-227X},
  language     = {eng},
  month        = {06},
  number       = {12},
  publisher    = {BioMed Central (BMC)},
  series       = {BMC Emergency Medicine},
  title        = {Negative predictive value and potential cost savings of acute nuclear myocardial perfusion imaging in low risk patients with suspected acute coronary syndrome : A prospective single blinded study},
  url          = {http://dx.doi.org/10.1186/1471-227X-9-12},
  doi          = {10.1186/1471-227X-9-12},
  volume       = {9},
  year         = {2009},
}