Abstract
In 2008 in Taiwan, the National Health Insurance (NHI) administration revised the guidelines regarding appropriately utilizing percutaneous coronary intervention (PCI) for patients with stable CAD to mandatory demonstration of functional ischemia by treadmill exercise test (TET), stress echocardiography (SE) or MPI. Notably, anatomic-based non-invasive imaging with coronary computed tomography (CT) angiography remains not reimbursed by Taiwan's NHI. According to the NHI database, the total number of MPI significantly increased from 34,016 in 2000 to 151,254 in 2016 with an annual growth rate of 21.5%, much higher than the 7.9% growth of overall nuclear medicine tests during this period. Recently we investigated the frequency of stress testing within 90 days prior to PCI for stable CAD and showed that 79.1% of patients had MPI, 66.4% had TET and only 0.05% had SE. We conclude that MPI currently plays a gatekeeper role for invasive coronary procedures for stable CAD in Taiwan.
