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Asher A, Ghelani R, Thornton G, et al. UK perspective on the changing landscape of non-invasive cardiac testing. Open Heart. 2019;6(2):e001186doi: 10.1136/openhrt-2019-001186.
Asher, A., Ghelani, R., Thornton, G., Rathod, K., Jones, D., Wragg, A., & Timmis, A. (2019). UK perspective on the changing landscape of non-invasive cardiac testing. Open heart, 6(2), e001186. https://doi.org/10.1136/openhrt-2019-001186
Asher, Alex, et al. "UK perspective on the changing landscape of non-invasive cardiac testing." Open heart vol. 6,2 (2019): e001186. doi: https://doi.org/10.1136/openhrt-2019-001186
Asher A, Ghelani R, Thornton G, Rathod K, Jones D, Wragg A, Timmis A. UK perspective on the changing landscape of non-invasive cardiac testing. Open Heart. 2019 Dec 05;6(2):e001186. doi: 10.1136/openhrt-2019-001186. eCollection 2019. PMID: 31908814; PMCID: PMC6927513.
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Open Heart. 2019 Dec 05;6(2):e001186. doi: 10.1136/openhrt-2019-001186. eCollection 2019.

UK perspective on the changing landscape of non-invasive cardiac testing.

Open heart

Alex Asher, Rahul Ghelani, George Thornton, Krishnaraj Rathod, Daniel Jones, Andrew Wragg, Adam Timmis

Affiliations

  1. Cardiology, Barts Health NHS Trust, London, UK.
  2. Faculty of Medicine and Dentistry, Barts and The London School of Medicine and Dentistry Postgraduate Studies, London, UK.

PMID: 31908814 PMCID: PMC6927513 DOI: 10.1136/openhrt-2019-001186

Abstract

OBJECTIVE: To document UK rates of exercise treadmill testing, functional stress testing and CT coronary angiography (CTCA). Specific aims were to determine how rates have changed in the context of changing guideline recommendations within the UK and to identify regional inequalities in the utilisation of testing modalities. Secondary objectives were to compare these trends with national data on revascularisation.

METHODS: 159 acute National Health Service trusts were served Freedom of Information (FOI) requests to provide total numbers of CTCA and functional imaging tests for each financial year from 2011-2012 to 2016-2017.

RESULTS: The FOI requests yielded data from 88% of Trusts, increasing from 81.9% in 2011-2012% to 92.1% in 2016-2017. Exercise treadmill tests (ETTs) were performed by over 97% of Trusts. ETT was the most commonly performed diagnostic test in the UK across the study period despite declining by 8.4%. Utilisation of non-invasive stress imaging tests increased by 80.9% during the same period. Myocardial perfusion scintigraphy and stress echocardiography increased by 25.8% and 73.9%, respectively. The 268% increase in CTCA scans was yet greater. Trends in test utilisation during the study period showed important regional differences between devolved nations. Comparably, only small changes in rates of invasive coronary angiography and revascularisation have been reported during the study period.

CONCLUSION: Non-invasive imaging in UK Trusts has increased substantially since 2010 with only a small decline in use of the ETT and minimal changes in rates of invasive coronary angiography and revascularisation in the same time period.

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords: coronary artery disease; echocardiography; electrocardiography

Conflict of interest statement

Competing interests: None declared.

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