Nationwide trends of gatekeeper to invasive coronary angiography in suspected coronary artery disease

Abstract Funding Acknowledgements Type of funding sources: None. Background and Objectives Real-world trends in the utility type gatekeeping studies invasive coronary angiography (ICA) requires further investigation. Methods We identified outpatients who underwent noninvasive cardiac tests or directly ICA for suspected artery disease (CAD) from nationwide Korea Health Insurance Review Assessment Service-National Patient Sample database between 2012 2018. Results Among 71,401 patients, percentage patients were evaluated CAD was 34.7% treadmill test (TMT), 4.2% single-photon emission computed tomography (SPECT), 24.2% (CCTA), 1.6% multiple gatekeepers, 32.3% without (Figure 1). The proportion CCTA as a gatekeeper showed linear increase, (18.6% 28.8% 2018; p < 0.001), while those TMT, SPECT, direct have decreased (p 0.001, = 0.03, respectively). overall incidence downstream after 13.8% (6,662/48,346), SPECT higher rate pairwise comparison with TMT 0.001). Patients performed gatekeepers before subsequent PCI (34.7% vs. 32.3%; 0.001) CABG (3.5% 1.0%; compared to ICA, associated revascularization Conclusion Nationwide demonstrated that is utilized increasingly high CAD.