Study Faults High Number of Angiograms

Yet again, another <"">medical test is being found to be over utilized, says a study published in the recent issue of the New England Journal of Medicine, reports the Star Tribune. It seems that a significantly large percentage of patients in the United States who undergo an angiogram procedure, do not have serious cardiac problems, said the Star Tribune.

Angiograms are used to search for heart disease and involve the threading of a thin tube into the heart to look for blockages, said the Star Tribune; the procedure carries with it a one-percent risk of stroke or heart attack. The Star Tribune noted that the procedure also involves exposure to radiation. Generally the procedure is used on patients who might be having a heart attack or whose symptoms point to a serious blockage, said the Star Tribune; however sometimes the procedure is conducted on patients with no or with questionable symptoms or “traits.”

Angiograms are conducted on, for instance, patients who test with high cholesterol, which occurs 20-to-30-percent of the time, said the Star Tribune. The study found that in this group, of the patients tested, most—a large two-thirds—did not have a serious blockage, said the Star Tribune. Some 400,000 patient records were analyzed for the study, said Bloomberg News.

The majority of the patients were prescribed angiograms following an initial screening that pointed to the potential for clogged arteries—which can point to the existence of heart disease—but which turned out to be less than initially believed, explained Bloomberg News.

Citing the study, Bloomberg News pointed out that overuse of these elective procedures is a contributing factor in the increasing trend in U.S. health care costs. The study also pointed to a need for improved diagnostic tools. “We need to improve all the things we do before we get to the cath lab…. But we need more large-scale studies to give doctors the guidance they require to make these calls.” said Manesh Patel, a cardiologist at Duke University in Durham, North Carolina, and one of the authors of the study, in a telephone interview, quoted Bloomberg News.

The spending on imaging services, such as angiograms, a factor in increased health care costs, has doubled to a whopping $14 billion in 2006 versus 2000, said Bloomberg News. Also, as we have been writing, more and more, Americans are exposed to increasing amounts of radiation. Bloomberg News reported that, in the United States, Americans are exposed to double the radiation over exposures 30 years ago, due to a “six-fold” increase in medical imaging tests, according to David Brenner. Brenner is the director of the Center for Radiological Research at Columbia University.

In Brenner’s telephone interview, said Bloomberg News, he said that Patel’s study “shows that too many people are having invasive tests that are associated with exposure to radiation.” A move to cardiac computer tomography, over stress tests, could be more effective at locating blockages, said Brenner; however, the tests are costly and do expose patients to radiation, but would, nevertheless, reduce the incidence of catheterizations, thus reducing costs.

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