ASNC: Stress SPECT Reduces Resource Use in MI Care

SAN DIEGO, Sept. 17 -- Risk stratification using single-photon emission computed tomography (SPECT) led to shorter stays and fewer readmissions for hospitalized heart attack patients, investigators reported here.
Average length of stay was more than half a day shorter compared with stays of patients who did not have SPECT and 12-month post-discharge hospital days were cut by 1.5, James Spalding, PharmD, reported at the American Society of Nuclear Cardiology meeting.
Use of coronary angiography and revascularization procedures was also lower in patients who had SPECT imaging while in the hospital.
No consensus exists about the best strategy for risk stratification of MI survivors, Dr. Spalding noted. However, he said, SPECT imaging has demonstrated potential for identifying patients who might be candidates for early discharge.
The current study evaluated the impact of SPECT on hospital utilization, angiography, and revascularization in MI survivors. Investigators retrospectively reviewed claims data on five million Medicare and privately insured patients hospitalized for acute MI from 1998 through 2005.
Hospital stays were classified according to whether SPECT imaging was performed during the stay. The records identified 3,139 patients who'd had stress SPECT an average of 2.7 days after admission (and no later than 10 days). Of those patients, 3,094 could be matched with MI survivors who did not have stress SPECT during hospitalization.
The two patient groups were comparable with respect to demographics, medical and pharmacy costs one year prior to admission, and one-year history of cardiac co-morbidities and procedures.
The researchers found that stress SPECT was associated with significant reductions in:
Length of hospital stay (7.9 versus 8.5 days, P<0.05)
Total hospital days in the 12 months after admission (19.7 versus 21.2, P<0.05)
Coronary angiography (53% versus 68%, P<0.05)
Revascularization procedures (10% versus 16%, P<0.05)
Dr. Spalding concluded that the results are consistent with those of the INSPIRE trial, which showed that post-MI SPECT stress imaging can safely and accurately identify low-risk patients (J Am Coll Cardiol 2006;48:2448-2457).
Dr. Spalding is an employee of Astellas Pharma, which funded the study. Primary source: American Society of Nuclear CardiologySource reference: Wu EQ et al. "Impact of single-photon emission computed tomography use after acute myocardial infarction on hospital utilization and cardiac procedure rates." J Nucl Cardiol. 2007;14(suppl):S115. Abstract 16.33.