Application of appropriate use criteria for percutaneous coronary intervention in Japan

Figure 3 Association between temporal trends in non-invasive tests and frequency of inappropriate ratings. The proportion of patients evaluated with CCTA and FFR substantially increased (both P for trend < 0.001), which coincided with a decrease in utilization of stress myocardial perfusion imaging over the course of 5 years (P for trend < 0.001). Contemporaneously, the proportion of inappropriate PCIs increased (P for trend = 0.003) in parallel with the increase in utilization of CCTA. The gray area indicates the percentages of inappropriate procedures based on original appropriateness criteria (AUC/2009). From Inohara et al[17]. CCTA: Coronary computed tomography angiography; MPI: Myocardial perfusion imaging; FFR: Functional flow reserve.