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:5/4/2016)... ... May 04, 2016 , ... ... 2016, a powerful cellular therapy software application that helps blood and marrow transplant ... , Since Transtem’s initial launch, Mediware has continued to enhance core application features. ...
(Date:5/4/2016)... ... May 04, 2016 , ... International Conference on Obesity and ... 2016 at Las Vegas. It aims to bring together academicians, scientists, dietitians, surgeons, ... organizations across the globe; making the conference a perfect platform to share experience ...
(Date:5/3/2016)... ... May 04, 2016 , ... The National Association of Professional Women (NAPW) ... of the Year Circle. She is recognized with this prestigious distinction for leadership in ... than 850,000 members and over 200 operating Local Chapters. , “I’m pleased to welcome ...
(Date:5/3/2016)... ... , ... Sue Desmond-Hellmann, chief executive officer of the Bill & Melinda Gates ... possibility in her keynote address at Georgia State University’s spring commencement on ... rich experience as a scientist, physician and executive, Desmond-Hellmann leads the Gates Foundation’s efforts ...
(Date:5/3/2016)... Baltimore, Md. (PRWEB) , ... May 03, 2016 , ... ... devastating consequences of inappropriate or excessive levels of alcohol use. Alcohol and its ... fetal alcohol spectrum disorders to the susceptibility to strokes in those 65 years and ...
Breaking Medicine News(10 mins):
(Date:5/3/2016)... Mo. , May 3, 2016 ... Medical Center,s Institute for Advancing Medical Innovation (IAMI) ... commercialize new drugs, diagnostics and medical devices. ... BioNovus Innovations with rights to license, develop and ... "This partnership represents a ...
(Date:5/3/2016)... Ore. , May 3, 2016   ... medical technology, today announced Food and Drug Administration ... resynchronization defibrillator that provides heart failure patients with ... Iperia devices also have remote monitoring with daily ... adapts the heart rate in response to physiological ...
(Date:5/3/2016)... According to market research "Global ... and Demand Forecast to 2022 - Industry Insights by ... Very High Field, Low to Mid Field, and Ultra ... Musculoskeletal, Vascular, Breast, Pelvic and Abdomen, Cardiac, and Other)" ... market was valued at $5,351.7 million in 2015, and ...
Breaking Medicine Technology: