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Brief Summary

GUIDELINE TITLE

Myocardial perfusion scintigraphy for the diagnosis and management of angina and myocardial infarction.

BIBLIOGRAPHIC SOURCE(S)

  • National Institute for Clinical Excellence (NICE). Myocardial perfusion scintigraphy for the diagnosis and management of angina and myocardial infarction. London (UK): National Institute for Clinical Excellence (NICE); 2003 Nov. 25 p. (Technology appraisal; no. 73).

GUIDELINE STATUS

This is the current release of the guideline.

BRIEF SUMMARY CONTENT

 
RECOMMENDATIONS
 EVIDENCE SUPPORTING THE RECOMMENDATIONS
 IDENTIFYING INFORMATION AND AVAILABILITY
 DISCLAIMER

 Go to the Complete Summary

RECOMMENDATIONS

MAJOR RECOMMENDATIONS

This appraisal covers the use of myocardial perfusion scintigraphy (MPS) using single photon emission computed tomography (SPECT) in the diagnosis and management of angina and myocardial infarction. It does not cover planar MPS or the use of MPS in the management of heart failure or in the assessment of myocardial viability. In this guidance the term coronary artery disease (CAD) is used to refer to angina and myocardial infarction.

  • MPS using SPECT is recommended for the diagnosis of suspected coronary artery disease (CAD) in the following circumstances.
    • As the initial diagnostic tool for people with suspected CAD for whom stress electrocardiography poses particular problems of poor sensitivity or difficulties in interpretation, including women, patients with cardiac conduction defects (for example, left bundle branch block), and people with diabetes, and for people for whom treadmill exercise is difficult or impossible.
    • As part of an investigational strategy for the diagnosis of suspected CAD in people with lower likelihood of CAD and of future cardiac events. The likelihood of CAD will be based on the assessment of a number of risk factors including age, gender, ethnic group, family history, associated comorbidities, clinical presentation, physical examination, and results from other investigations (for example, blood cholesterol levels or resting electrocardiogram).
  • MPS using SPECT is recommended as part of the investigational strategy in the management of established CAD in people who remain symptomatic following myocardial infarction or reperfusion interventions.

CLINICAL ALGORITHM(S)

None provided

EVIDENCE SUPPORTING THE RECOMMENDATIONS

TYPE OF EVIDENCE SUPPORTING THE RECOMMENDATIONS

The type of evidence supporting the recommendations is not specifically stated.

For clinical effectiveness, much of the evidence consisted of nonrandomised open observational (both prospective and retrospective) studies, with several studies using a comparative design.

IDENTIFYING INFORMATION AND AVAILABILITY

BIBLIOGRAPHIC SOURCE(S)

  • National Institute for Clinical Excellence (NICE). Myocardial perfusion scintigraphy for the diagnosis and management of angina and myocardial infarction. London (UK): National Institute for Clinical Excellence (NICE); 2003 Nov. 25 p. (Technology appraisal; no. 73).

ADAPTATION

Not applicable: The guideline was not adapted from another source.

DATE RELEASED

2003 Nov

GUIDELINE DEVELOPER(S)

National Institute for Health and Clinical Excellence (NICE) - National Government Agency [Non-U.S.]

SOURCE(S) OF FUNDING

National Institute for Health and Clinical Excellence (NICE)

GUIDELINE COMMITTEE

Appraisal Committee

COMPOSITION OF GROUP THAT AUTHORED THE GUIDELINE

Committee Members: Dr A E Ades, MRC Senior Scientist, MRC Health Services Research Collaboration, Department of Social Medicine, University of Bristol; Professor Ron Akehurst, Dean, School of Health Related Research, University of Sheffield; Dr Tom Aslan, General Practitioner, Stockwell, London; Professor David Barnett (Chair) Professor of Clinical Pharmacology, University of Leicester; Dr Sheila Bird, MRC Biostatistics Unit, Cambridge; Professor Rosamund Bryar, Professor of Community and Primary Care Nursing, St Bartholomew's School of Nursing and Midwifery, London; Dr Karl Claxton, Health Economist, University of York; Professor Terry Feest, Clinical Director & Consultant, Nephrologist, Richard Bright Renal Unit, & Chair of UK Renal Registry, Bristol; Professor Gary A Ford, Professor of Pharmacology of Old Age/Consultant Physician, Newcastle-upon-Tyne Hospitals, NHS Trust; Dr John Geddes, Consultant Psychiatrist, University Department of Psychiatrists, Oxford; Ms Bethan George, Interface Liaison Pharmacist, Tower Hamlets PCT and Royal London Hospital, Whitechapel; Dr Trevor Gibbs, Head, Global Clinical Safety and Pharmacovigilance, GlaxoSmithKline, Greenford; Mr John Goulston, Director of Finance, Barts and The London NHS Trust; Professor Philip Home, Professor of Diabetes Medicine, University of Newcastle-upon-Tyne; Dr Terry John, General Practitioner, The Firs, London; Mr Muntzer Mughal, Consultant Surgeon, Lancashire Teaching Hospitals NHS Trust, Chorley; Judith Paget, Chief Executive, Caerphilly Local Health Board, Torfaen; Mrs Kathryn Roberts, Nurse Practitioner, Hyde, Cheshire; Ms Anne Smith, Lay Representative; Trustee, Long-Term Medical Conditions Alliance; Dr Cathryn Thomas, General Practitioner, & Senior Lecturer, Department of Primary Care & General Practice, University of Birmingham; Dr Norman Vetter Reader, Department of Epidemiology, Statistics and Public Health, College of Medicine, University of Wales, Cardiff; Dr David Winfield, Consultant Haematologist, Royal Hallamshire Hospital, Sheffield

FINANCIAL DISCLOSURES/CONFLICTS OF INTEREST

Committee members are asked to declare any interests in the technology to be appraised. If it is considered there is a conflict of interest, the member is excluded from participating further in that appraisal.

GUIDELINE STATUS

This is the current release of the guideline.

GUIDELINE AVAILABILITY

AVAILABILITY OF COMPANION DOCUMENTS

The following are available:

Print copies: Available from the National Health Service (NHS) Response Line 0870 1555 455. ref: N0372. 11 Strand, London, WC2N 5HR.

Additionally, Audit Criteria can be found in Appendix C of the original guideline document.

PATIENT RESOURCES

The following is available:

  • Myocardial perfusion scintigraphy for the diagnosis and management of angina and myocardial infarction. Understanding NICE guidance - information for people with angina and myocardial infarction (coronary artery disease), their families and carers, and the public. London (UK): National Institute for Health and Clinical Excellence (NICE); 2003 Nov. 10 p. (Technology appraisal 73).

Electronic copies: Available in Portable Document Format (PDF) from the National Institute for Health and Clinical Excellence (NICE) Web site.

Print copies: Available from the Department of Health Publications Order Line 0870 1555 455. ref: N0373. 11 Strand, London, WC2N 5HR.

Please note: This patient information is intended to provide health professionals with information to share with their patients to help them better understand their health and their diagnosed disorders. By providing access to this patient information, it is not the intention of NGC to provide specific medical advice for particular patients. Rather we urge patients and their representatives to review this material and then to consult with a licensed health professional for evaluation of treatment options suitable for them as well as for diagnosis and answers to their personal medical questions. This patient information has been derived and prepared from a guideline for health care professionals included on NGC by the authors or publishers of that original guideline. The patient information is not reviewed by NGC to establish whether or not it accurately reflects the original guideline's content.

NGC STATUS

COPYRIGHT STATEMENT

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions.

DISCLAIMER

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