LWW/JACM JACM3304-04 August 31, 2010 21:16 Char Count= 0 J Ambulatory Care Manage Vol. 33, No. 4, pp. 328–335 Copyright c  2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Ambulatory Cardiac Single-Photon Emission Computed Tomography at the Primary Care Physician’s Office A Descriptive Study Nayla Chaptini, MD; Venkata Satish Dontaraju, MD; Frederman Concepcion, MD; Hazem Al Muradi, MD; Tareq Alyousef, MD; Maria Del Pilar Aristiz ´ abal Canaval, MD; Rami Doukky, MD, FACC, FASNC Abstract: Ambulatory cardiac single-photon emission computed tomography stress testing for the evaluation of coronary artery disease at the primary care physician’s office is increasingly utilized without data supporting its safety. In this 2-year prospective pilot study of 1266 consecutive stress- myocardial perfusion imaging studies done in the primary care physician’s office using a mobile nuclear cardiology laboratory, adverse events were mild and rare. There were no recorded events of myocardial infarction, serious arrhythmias, severe bronchospasm, hospitalization, or death. This suggests that this practice is safe in this population with these providers. This finding may not apply to a higher-risk population. Further evaluation of referral appropriateness and long-term prognostic value is needed. Key words: adverse events, ambulatory, cardiac SPECT, mobile nuclear cardiology laboratory, myocardial perfusion imaging, point-of-care testing, primary care physician, safety, stress testing Author Affiliations: Section of Cardiology, Rush University Medical Center (Dr Doukky) and Division of Adult of Cardiology/Department of Medicine, John H. Stroger, Jr Hospital of Cook County (Drs Chaptini, Dontaraju, Conception, Al Muradi, Alyousef, Canaval, and Doukky) Chicago, Illinois. Disclaimer: Rami Doukky, MD: (1) President of mo- bile nuclear cardiology laboratory; and (2) ICANL med- ical director of Digirad Imaging Services TM laboratory. No funding was received from either company to con- duct the study. No private research funding sources to be declared. Other authors: No conflicts of interest to be reported. This study was internally funded by Section of Cardi- ology, Rush University Medical Center and Division of Adult Cardiology of John H. Stroger Jr. Hospital of Cook County. Correspondence: Rami Doukky, MD, FACC, FASNC, Section of Cardiology, Rush University Medical Center, 1653 W. Congress Pkwy. Jelke Bldg. Ste #1015d, Chicago, IL 60612 (rami doukky@rush.edu). M YOCARDIAL PERFUSION IMAGING (MPI) by single-photon emission computed tomography (SPECT) has been increasingly utilized in the past 2 decades for the evaluation of various presentations of coronary artery disease (CAD) (Hendel, 2008a, 2008b). It is frequently utilized by the primary care physician (PCP) for the assess- ment of a variety of nonacute presentations, many of which are deemed appropriate by the multisocietal appropriateness criteria of cardiac radionuclide imaging (Hendel et al., 2009). For decades, SPECT-MPI has been performed in hospital settings or at the cardiologist’s office. Less frequently, large primary care practices have implemented stationary SPECT-MPI imaging systems in the office. This approach can be cost-effective only in large, high-volume practices. The Copyright © 2010 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. 328