Temporal changes in stress echocardiography practice across the UK: insight from the BSE?NSTEP multi?centre study.
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All Authors
Johnson, C.
Krasner, S.
Mao, E.
Woodward, W.
McCourt, A.
Dockerill, C.
Monaghan, M.
Senior, R.
Augustine, D.
Paton, M.
LTHT Author
Paton, Maria
LTHT Department
Cardio-Respiratory
Cardiology
Cardiology
Non Medic
Highly Specialist Cardiac Physiologist
Publication Date
2024
Item Type
Conference Abstract
Language
Subject
Subject Headings
Abstract
Background: Stress echocardiography (SE) is widely used to detect coronary artery disease (CAD), but recent changes in clinical guidelines, clinical practice, and public health may have shifted both the population being referred for SE and the manner in which SE is conducted. Purpose(s): To identify temporal changes in the patient demographics of those being investigated with SE and the method of SE practice across NHS Trusts in the UK. Method(s): Participant demographics and SE procedure details were collected for 13,781 participants as part of the multi-centre BSENSTEP study. Data was acquired from March 2015-September 2020 as part of Groups 1 and 2 of the study, and October 2020-May 2023 as Group 3. Comparisons were conducted for the overall cohorts and further according SE result (positive or negative). Descriptive statistics were investigated as frequencies and medians [interquartile range (IQR)]. Comparison of discrete data was conducted using Pearson's ?2 tests. Result(s): Data was collected for 7504 participants across 30 NHS Trusts as part of Group 1/2 and a further 6,277 across 34 NHS Trusts as part of Group 3. In overall cohort comparison of Group 1/2 vs Group 3 (Table 1), number of non-smokers (49.5% vs 53.6%), prevalence of hypertension (48.4% vs 52.9%), hypercholesterolaemia (39.9% vs 47.4%), diabetes (19.9% vs 22.7%), and family history of premature CAD (6.8% vs 33.7%) was higher in Group 3, while previous percutaneous coronary intervention was lower (32.5% vs 21.0%) (all p < 0.001). Exercise SE (30.5% vs 37.4%), and use of contrast enhancement (71.9% vs 83.6%) was more common in Group 3, but use of Atropine in Dobutamine SE was lower (49.4% vs 44.3%) (all p < 0.001). These results are further broken into positive and negative SE result in Tables 2 and 3 respectively. Conclusion(s): This study provides evidence of potential effects from recent clinical guideline changes and subsequent clinical practice as well as the changing landscape of patients being referred for SE.
Journal
Echo Research and Practice