The Particulars: Myocardial perfusion imaging (MPI) using cardiac positron emission tomography (PET) is increasingly being used to evaluate patients with suspected or known coronary artery disease (CAD). Whether cardiac PET is an effective gatekeeper to the cardiac catheterization laboratory has not been well defined.

Data Breakdown: Researchers who started a perfusion cardiac PET service conducted a study to determine the impact of this service on the rate of normal coronary angiography. Prior to starting the service, the rate of obstructive CAD on angiography was 70.6%, compared with a rate of 73.0% observed among all comers after the service was initiated. The rate of obstructive disease was 81.5% among patients who underwent angiography after cardiac PET, compared with a rate of 72.0% among those who underwent coronary angiography without a preceding cardiac PET.

Take Home Pearl: The yield of coronary angiography appears to be significantly higher in patients who undergo cardiac PET prior to coronary angiography.