Growing Use of Cardiac Stress Testing in the U.S.

Concern has been growing that cardiac stress testing — especially with imaging — often is performed unnecessarily. Researchers used data from U.S. national ambulatory surveys to track trends in use of these procedures between 1993 and 2010 among patients without known coronary disease.

During this 18-year period, the average rate of stress testing overall increased from 28 tests to 48 tests per 10,000 outpatient visits. The proportion of stress tests done with imaging (either nuclear or echocardiographic) increased from 59% to 87%. Applying multisociety appropriateness guidelines to testing performed between 2005 and 2010, the researchers estimated that 14% of stress tests without imaging and 30% of tests with imaging would be “rarely approp…