Featured Research

from universities, journals, and other organizations

Best Use For Popular Coronary Artery Disease Assessment Procedure Is Misunderstood

Date:
April 14, 2008
Source:
University of Virginia Health System
Summary:
What is the best way to determine if you are developing the nation's most deadly condition, coronary artery disease (CAD)? An increasing number of doctors are encouraging patients -- especially those deemed to be at high-risk for developing CAD -- to undergo a noninvasive imaging procedure called coronary computed tomography angiography, or coronary CTA, to see if plaque deposits are accumulating in their arteries. According to new research widespread use of CTA for screening purposes may be inappropriate.

What is the best way to determine if you are developing the nation's most deadly condition, coronary artery disease (CAD)?

Related Articles


An increasing number of doctors are encouraging patients - especially those deemed to be at high-risk for developing CAD - to undergo a non-invasive imaging procedure called coronary computed tomography angiography, or coronary CTA, to see if plaque deposits are accumulating in their arteries.

According to Dr. Christopher M. Kramer, a professor of Radiology and Medicine at the University of Virginia Health System, widespread use of CTA for screening purposes may be inappropriate. "There seems to be a lot of misunderstanding about CTA. People need to know that it is not intended to be a screening test," he says.

In a recent article in Circulation, Dr. Kramer asserted that doctors should not order coronary CTA to assess every high-risk patient. "This procedure exposes people to radiation and contrast dye, both of which can have adverse affects," he notes. "When individuals don't have symptoms of CAD, such as chest pain, coronary CTA may pose more risk than benefit."

Nationally, much study and debate surrounds the use and clinical value of coronary CTA as a screening tool. Medicare reimbursement is also under review. Currently, all 50 states provide Medicare coverage when coronary CTA is performed on patients with symptoms, but U.S. Centers for Medicare and Medicaid Services (CMS) has expressed uncertainty about its benefits. CMS recently postponed implementation of more stringent coverage limits for coronary CTA until further research is completed.

Coronary CTA has been gaining in popularity because it is a fast and relatively inexpensive way to see exactly how much plaque has accumulated in arteries that supply blood to the heart. It is the only noninvasive test that shows what kinds of plaque are building up - either the hard, calcified type or soft, fatty deposits - and directly reveals if blockages are forming.

From start to finish, the procedure takes about 10 minutes. Preparations begin with an injection of iodine-containing contrast dye into an intravenous (IV) line in the patient's arm. Some patients also receive medication to slow or stabilize their heart rate. During a coronary CTA, doctors use a high-resolution, three-dimensional scanner to take X-rays of a patient's beating heart and surrounding blood vessels.

Whether or not patients have symptoms, they are considered to be at high risk for CAD when they have several of the following factors: elevated blood pressure, smoking, high cholesterol, excess body weight, diabetes, stress, poor diet and/or lack of proper exercise. Being older, male and having a family history of CAD increases risk levels.

As Dr. Kramer sees it, understanding the best use of coronary CTA will require more time and studies. So far, it has proven useful in three groups: patients with low-to-intermediate CAD risk factors who have chest pain; patients with CAD symptoms and left bundle-branch block - a blockage that causes the left ventricle of the heart to contract later than the right ventricle; and, patients preparing for cardiac valve surgery.

Current medical guidelines call for doctors to aggressively treat all patients at high risk for CAD without ordering tests like coronary CTA. According to Dr. Kramer, a CT procedure called calcium scoring, which uses no contrast dye and much less radiation, may be appropriate for screening patients who are at risk for CAD and have not developed symptoms.


Story Source:

The above story is based on materials provided by University of Virginia Health System. Note: Materials may be edited for content and length.


Cite This Page:

University of Virginia Health System. "Best Use For Popular Coronary Artery Disease Assessment Procedure Is Misunderstood." ScienceDaily. ScienceDaily, 14 April 2008. <www.sciencedaily.com/releases/2008/04/080414170010.htm>.
University of Virginia Health System. (2008, April 14). Best Use For Popular Coronary Artery Disease Assessment Procedure Is Misunderstood. ScienceDaily. Retrieved October 24, 2014 from www.sciencedaily.com/releases/2008/04/080414170010.htm
University of Virginia Health System. "Best Use For Popular Coronary Artery Disease Assessment Procedure Is Misunderstood." ScienceDaily. www.sciencedaily.com/releases/2008/04/080414170010.htm (accessed October 24, 2014).

Share This



More Health & Medicine News

Friday, October 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

IKEA Desk Converts From Standing to Sitting With One Button

IKEA Desk Converts From Standing to Sitting With One Button

Buzz60 (Oct. 24, 2014) IKEA is out with a new convertible desk that can convert from a sitting desk to a standing one with just the push of a button. Jen Markham explains. Video provided by Buzz60
Powered by NewsLook.com
Ebola Protective Suits Being Made in China

Ebola Protective Suits Being Made in China

AFP (Oct. 24, 2014) A factory in China is busy making Ebola protective suits for healthcare workers and others fighting the spread of the virus. Duration: 00:38 Video provided by AFP
Powered by NewsLook.com
WHO: Millions of Ebola Vaccine Doses by 2015

WHO: Millions of Ebola Vaccine Doses by 2015

AP (Oct. 24, 2014) The World Health Organization said on Friday that millions of doses of two experimental Ebola vaccines could be ready for use in 2015 and five more experimental vaccines would start being tested in March. (Oct. 24) Video provided by AP
Powered by NewsLook.com
Doctor in NYC Quarantined With Ebola

Doctor in NYC Quarantined With Ebola

AP (Oct. 24, 2014) An emergency room doctor who recently returned to the city after treating Ebola patients in West Africa has tested positive for the virus. He's quarantined in a hospital. (Oct. 24) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins