Rates of Cardiac Stress Testing Down but Still Higher in CKD

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Decline in rates of cardiac stress testing in Medicare beneficiaries aged ≥66 years from 2008 to 2012.
Decline in rates of cardiac stress testing in Medicare beneficiaries aged ≥66 years from 2008 to 2012.

(HealthDay News) -- From 2008 to 2012 there was a decrease in overall rates of cardiac stress testing in Medicare beneficiaries, though rates were consistently higher for patients with chronic kidney disease (CKD) than those without CKD, according to a study published online in JACC: Cardiovascular Imaging.

Charles A. Herzog, MD, from the University of Minnesota in Minneapolis, and colleagues identified Medicare beneficiaries aged 66 years or older undergoing a first cardiac stress test from 2008 to 2012. Testing rates were compared for patients with CKD and those without CKD.

About 480,000 patients underwent stress tests in 2008 (about 29,000 with CKD) compared with about 400,000 patients in 2012 (about 38,000 with CKD). The researchers found that in 2008 and 2012, 78 to 80% and 87 to 88% of all stress testing in non-CKD and CKD patients, respectively, used nuclear imaging. From 2008 to 2012 there was a decrease in the rate of stress testing, from 11.5 to 9.4 per 100 patient years for non-CKD patients and from 16.8 to 13.4 per 100 patient-years for CKD patients. With non-CKD as the reference, the likelihood of stress testing increased with worsening CKD.

"Overall rates of cardiac stress testing (over three-fourths using nuclear imaging) declined 2008 to 2012 in Medicare beneficiaries aged 66 years or older, but were consistently higher for CKD than for non-CKD patients," the authors write.

Reference

Herzog CA, Natwick T, Li S, and Charytan DM. Comparative Utilization and Temporal Trends in Cardiac Stress Testing in U.S. Medicare Beneficiaries With and Without Chronic Kidney Disease. JACC: Cardio Imag. June 2018. DOI: 10.1016/j.jcmg.2018.04.012

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