Navigation Links
Are Post-Angioplasty Stress Tests Unnecessary?
Date:5/15/2012

By Steven Reinberg
HealthDay Reporter

TUESDAY, May 15 (HealthDay News) -- After patients undergo heart procedures to open blocked arteries, it may not be useful to give them treadmill stress tests with echocardiograms if they don't have symptoms such as chest pain or shortness of breath, a new study suggests.

"There are very large populations of post-angioplasty and post-bypass patients; screening asymptomatic patients probably isn't useful," said lead researcher and cardiologist Dr. Thomas Marwick, of the Cleveland Clinic.

Identifying at-risk patients doesn't improve their outcomes even if they have another procedure, Marwick added. "We can identify risk better than we can treat it," he said.

Heart problems after these procedures are common and include impaired blood flow to the heart and worsening heart function, the researchers noted.

Guidelines of the American College of Cardiology/American Heart Association recommend stress imaging tests in symptomatic patients after revascularization, but testing patients without symptoms "is more controversial," the researchers noted.

The report was published in the May 14 online edition of the Archives of Internal Medicine.

To determine the effectiveness of stress testing after revascularization, Marwick's team gave echocardiogram stress tests to 2,105 patients who didn't have symptoms.

Among these patients, 40 percent had previous heart attacks, 54 percent had an angioplasty and 46 percent had bypass surgery to open blocked heart arteries.

The test revealed that 262 patients were at high risk for a heart attack. Of these, 88 had another procedure to unblock arteries.

Over almost six years of follow-up, 97 patients died. These deaths were associated with heart problems whether patients had stress tests early -- less than two years after an angioplasty or less than five years after bypass surgery -- or later following a procedure.

"Importantly, patients identified as high risk did not have more favorable outcomes if they had repeat revascularization," Marwick said.

The researchers concluded that a routine stress test that evaluates exercise capacity is sufficient to identify at-risk patients.

Standard stress tests involve monitoring a patient's blood pressure during exercise.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, commented that "there has been increased interest in whether the used of stress testing in asymptomatic patients with coronary artery disease after revascularization procedures can detect individuals at increased risk of subsequent events and be used to improve clinical outcomes."

This new study showed that in patients without symptoms, exercise echocardiographic stress testing did identify patients both early and late after revascularization at double the risk of dying, he said.

"Given that this testing provides independent prognostic information, further studies are needed to determine whether the findings from this testing is or is not useful for improving clinical outcomes," Fonarow said.

Stress testing combined with imaging can cost between $800 and $2,400 per test. "So, determining the comparative effectiveness of managing asymptomatic patients with or without stress testing is of considerable importance," he said.

More information

The U.S. National Heart, Lung, and Blood Institute has more about types of stress testing.

SOURCES: Thomas H. Marwick, M.D., Ph.D., M.P.H., Cleveland Clinic, Ohio; Gregg Fonarow, M.D., professor, cardiology, University of California, Los Angeles; May 14, 2012, Archives of Internal Medicine, online


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Early life stress may predict cardiovascular disease
2. Say “I Love You” From Head to Toe with a Gift That's Healthy and Soothes Away Stress this Valentine's Day
3. Tired of Snow, Sleet, and Stress? Join Deepak Chopra for a Week-Long Meditation Retreat this March in Florida's Warm Sunshine
4. New research shows emotional impact of low sexual desire and associated distress
5. Stress hormone, depression trigger obesity in girls
6. Brain Balancing Gives Hope for Sufferers of Depression, Stress, and Insomnia at New Life Brain Center
7. Family members reduce stress in advanced cancer patients with 14 minute massages
8. Childhood stress such as abuse or emotional neglect can result in structural brain changes
9. Good Parenting Triumphs Over Prenatal Stress
10. Promotional Stress Ball Supplier -- StressBallsUK.com Starts 2010 Strongest Ever
11. New research shows innovative respiratory stress test can quickly detect significant coronary artery disease in a noninvasive setting
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/2/2016)... ... December 02, 2016 , ... On Dec. 2, 2016, CURE® magazine will ... Diego honoring the 2016 MPN Heroes—eight individuals who have made a difference in the ... beyond the standard of care, demonstrating leadership within the MPN community and/or a commitment ...
(Date:12/2/2016)... ... December 02, 2016 , ... More than 100 business, civic, ... to attend the UNCF Dothan-Wiregrass Mayor’s Luncheon Dec. 9, 2016. This inaugural event, ... and operating support to UNCF-member institutions, including Miles College, Oakwood University, Tuskegee University, ...
(Date:12/2/2016)... ... December 02, 2016 , ... ... launch of its 60-day free trial program for all of the company’s desktop ... offer a truly hassle free experience. , FlexiSpot’s unique desktop risers use an ...
(Date:12/2/2016)... ... 2016 , ... The annual time frame to change Medicare health and prescription ... December 7th. Currently-enrolled Medicare beneficiaries who are looking to switch from their current plan ... to make changes during this period order for their new policy to go into ...
(Date:12/2/2016)... ... December 02, 2016 , ... With the number of pain ... an injury, patients must find the one that works for them. When an inventor ... a machine that worked and decided to share it with others. , He developed ...
Breaking Medicine News(10 mins):
(Date:12/2/2016)... In the first ever attempt to include ... from C. sativa, the Hebrew University in Jerusalem, the ... II , the Universita` del Piemonte Orientale and Phytoplant ... and unified inventory of phytocannabinoids of different botanical origin. ... remarkable chemical and structural diversity of phytocannabinoids. As a ...
(Date:12/2/2016)... bioLytical Laboratories, ein Weltführer bei schnellen Tests für Infektionskrankheiten, hat sein ... eingeführt. Continue Reading ... ... , ... ) bioLytical wurde durch die Clinton Health Access ...
(Date:12/2/2016)... N.J. , Dec. 2, 2016   CytoSorbents ... immunotherapy leader commercializing its European Union approved CytoSorb ... and cardiac surgery patients worldwide, announced that Dr. ... the 9th Annual LD Micro Main Event ... , 2016 at the Luxe Sunset Boulevard Hotel in ...
Breaking Medicine Technology: