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:6/24/2016)... CA (PRWEB) , ... June 24, 2016 , ... A ... procedures that most people are unfamiliar with. The article goes on to state that ... but also many of these less common operations such as calf and cheek reduction. ...
(Date:6/24/2016)... ... 2016 , ... June 19, 2016 is World Sickle Cell Observance Day. In ... benefits of holistic treatments, Serenity Recovery Center of Marne, Michigan, has issued ... Sickle Cell Disease (SCD) is a disorder of the red blood cells, which can ...
(Date:6/24/2016)... ... June 24, 2016 , ... The Pulmonary Hypertension ... that it will receive two significant new grants to support its work to ... its 25th anniversary by recognizing patients, medical professionals and scientists for their work ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... ... now offering micro-osteoperforation for accelerated orthodontic treatment. Dr. Cheng has extensive experience with ... Damon brackets , AcceleDent, and accelerated osteogenic orthodontics. , Micro-osteoperforation is a ...
(Date:6/24/2016)... , ... June 24, 2016 , ... Topical BioMedics, Inc, makers of Topricin and MyPainAway ... call for a minimum wage raise to $12 an hour by 2020 and then adjusting ... restore the lost value of the minimum wage, assure the wage floor does not erode ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016 Research ... MEMS Devices Medical Market Analysis 2016 - Forecast to 2022" ... The report contains up to date financial data ... analysis. Assessment of major trends with potential impact on the ... analysis of market segmentation which comprises of sub markets, regional ...
(Date:6/23/2016)... MOUNTAIN VIEW, Calif. , June 23, 2016 ... 9:00 a.m. CST on Thursday, July 7, 2016 , , ... kayla.belcher@frost.com ) , , , , EXPERT PANELISTS:  ... Sciences, Nitin Naik; Senior Industry Analyst, Christi Bird; Senior Industry Analyst, ... The global pharmaceutical industry is witnessing ...
(Date:6/23/2016)... , June 23, 2016  Guerbet announced today that ... Supplier Horizon Award . One of ... was recognized for its support of Premier members through ... clinical excellence, and commitment to lower costs. ... this recognition of our outstanding customer service from Premier," ...
Breaking Medicine Technology: