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. 2024 Dec 5:16:849-863.
doi: 10.2147/CLEP.S469538. eCollection 2024.

The Western Denmark Myocardial Perfusion Imaging Registry: A Review and Validation Study

Jacob Hartmann Søby  1 , Morten Schmidt  1   2 , Louise Nissen  1 , June Anita Ejlersen  3 , Lars Christian Gormsen  4   5 , Kasper Tholstrup Pedersen  6 , Paw Christian Holdgaard  7 , Jesper Mortensen  8 , Laust Dupont Rasmussen  1   9 , Søren Ravn  10 , Rika Horvat  11 , Simon Winther  1   2 , Morten Böttcher  1   2
Affiliations

The Western Denmark Myocardial Perfusion Imaging Registry: A Review and Validation Study

Jacob Hartmann Søby et al. Clin Epidemiol. .

Abstract

Purpose: Myocardial perfusion imaging (MPI) procedures from single photon emission computed tomography and positron emission tomography imaging have been registered in the Western Denmark Heart Registry (WDHR) since 2017 as a sub-registry (WDHR-MPI). The aim was to review the content, quality, and research potential of the WDHR-MPI and assess the completeness and validity of its key variables.

Patients and methods: Using the Danish National Patient Registry (DNPR) as a reference, we calculated the completeness of procedure registration as the proportion of procedures registered in the WDHR-MPI from 2017 to 2021. We defined completeness of variable registration as the proportion of non-missing values for a given variable and examined it for 38 key variables. We assessed validity by estimating the positive predictive values (PPV) and negative predictive values (NPV) with 95% confidence intervals (CI) for 26 selected key variables using corresponding extracted information from 300 randomly selected patient records.

Results: We identified 19,084 procedures in 17,871 patients from all seven cardiac centers performing nuclear cardiology procedures in the WDHR uptake area. The registry accumulated 4000-6000 procedures each year from 2019 to 2021. The overall completeness of procedure registration was 72% (95% CI 72-73), increasing from 14% (95% CI 13-15) in 2017 to 98% (95% CI 98-98) in 2021. The mean completeness of variable registration was 89%. The validity of entered data was high, with an overall PPV for the selected key variables of 95% (95% CI 94-95) and NPV of 94% (95% CI 93-96).

Conclusion: The WDHR-MPI is one of the largest systematic MPI cohorts. The overall high completeness and validity of the data support its potential for cardio-epidemiological research.

Keywords: cardiac imaging; chronic coronary syndromes; database; ischemic heart disease; registries; validation.

Plain language summary

If you have ischemic heart disease, you may experience symptoms such as chest tightness and shortness of breath due to decreased blood supply to the heart muscle. To help identify decreased blood supply to the heart muscle, doctors can use a specialized scan which involves the injection of low doses of radioactive tracers into the bloodstream. Since 2017, doctors in Denmark have been recording these scans in the Western Denmark Myocardial Perfusion Imaging Registry (WDHR-MPI). This study found a high completeness and validity of the registry. With 19,084 scans recorded from 2017 to 2021, this registry provides a high-quality resource that could improve diagnosis and treatment for people with heart disease.

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Conflict of interest statement

Morten Böttcher has participated in advisory boards for Astra-Zeneca, Bayer, Boehringer Ingelheim, Novartis, NOVO Nordisk, and Sanofi. The remaining authors have no conflicts of interest.

Figures

Figure 1
Figure 1
Source Population and Cardiac Centers with Nuclear Cardiology Contributing Data to the Western Denmark Myocardial Perfusion Imaging Registry (WDHR-MPI). The Western Denmark Heart Registry covers the three Western regions of Denmark. All cardiac centers in the area are depicted, and centers performing nuclear myocardial perfusion imaging are highlighted in circles with all of them reporting procedures to the Western Denmark Myocardial Perfusion Imaging Registry (WDHR-MPI).
Figure 2
Figure 2
Trends in Registrations and Completeness of Procedures in the Western Denmark Myocardial Perfusion Imaging Registry. (A) Annual number of positron emission tomography and single-photon emission computerized tomography myocardial perfusion imaging procedures registered in the Western Denmark Myocardial Perfusion Imaging Registry and Danish National Patient Registry. (B) Completeness of procedure registration calculated as the proportion of procedures registered in the Western Denmark Myocardial Perfusion Imaging Registry using the number of procedures with corresponding Civil Personal Register number and date of MPI procedure ±31 days in the Danish National Patient Registry as a reference. Completeness estimates are depicted as points with 95% confidence intervals as error bars.
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