Author Interviews, Heart Disease, JAMA, Radiology / 04.07.2016
Supply of Technetium-99m For Cardiac Stress Testing Constricted By Regulations and Aging Reactors
MedicalResearch.com Interview with:
Venkatesh Locharla Murthy MD,
PhD, FACC, FASNC
Assistant Professor, Internal Medicine
Frankel Cardiovascular Center
University of Michigan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Technetium-99m, which is very commonly used for cardiac stress testing, has had multiple supply disruptions due to aging nuclear reactors where it is produced coupled with changing regulations to minimize the risk of nuclear proliferation. The most severe of these disruptions occurred over six months in 2010.
We asked whether this disruption lead to changes in patterns of care among Medicare beneficiaries. We found that during this time, use of technetium-99m in nuclear stress testing fell from 64% to 49%, reflecting a shift towards thallium-201, which has higher radiation exposure and lower diagnostic specificity. This was reflected in a 9% increase in the rate of cardiac catheterization after a nuclear stress test during the study period, implying nearly 6,000 additional, possibly unnecessary, catheterizations during that time.
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