Temporal trends in pretest probability and normal scan rates in myocardial perfusion imaging: a 24-year experience from a Swiss tertiary referral center (between 2000 and 2024).

2) There was a slight trend to more relevant (11.0% → 13.2%) and less small (37.6% → 34.2%) ischaemia, whereas the quantitative extent of ischaemia overall did not decrease over time (unchanged SDS). 3) Median CACS and the proportion of patients with a CACS of 0 remained unchanged. 4) Overall, all ESC PTP models from the 2013, 2019, and 2024 guidelines underestimated the prevalence of abnormal MPI findings and small ischaemia.

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Also, in models not adjusting for (changing) risk factors over time, the results were similar, and calendar year was a highly significant predictor for the above-mentioned endpoints except for zero calcium score (see Supplementary data online , Table S3 ).

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