A retrospective comparative study of changes in nuclear medicine cardiac stress testing

We evaluated changes in the radiopharmaceuticals and the type of stress testing (either treadmill or pharmacological) used in a variety of nuclear medicine facilities over a 5-yr period, between 1991 and 1996, in Las Vegas, NV.

Nuclear cardiology patient records at three large hospitals, one large cardiology clinic and the two largest free-standing diagnostic centers in the Las Vegas Valley in 1991 were compared with patient data obtained from the same facilities in 1996. Patient data from each participating site was stratified into treadmill exercise, pharmacological stress testing and type of radiopharmaceutical used.

Nuclear medicine cardiology stress testing increased by 55%, from 1991 to 1996. Treadmill exercise testing increased by 14%, while pharmacologically-induced stress testing increased by 202%. All six facilities in the study changed their radiopharmaceutical of choice from thallium in 1991 to a technetium-labeled agent in 1996.

A large overall growth rate in nuclear medicine stress testing throughout the Las Vegas Valley occurred in hospitals and cardiology clinics between 1991 and 1996. The largest increase was seen in pharmacological stress testing. Over the same period, a decrease in referral base for nuclear stress testing was observed in two outpatient diagnostic centers. All facilities changed from thallium-based to either technetium-based radiopharmaceuticals or dual-isotope methods.