Coronary computed tomographic (CT) angiography, which can detect plaque buildup in heart vessels, is sometimes used as a screening tool to assess the risk for a heart attack. However, the usefulness of the test on low-risk patients who do not have coronary symptoms, such as chest pain, has been unclear.
In the first large population study to assess the impact of the test on physicians and patients, Johns Hopkins cardiologists found that having CT angiography leads to more prescriptions for cholesterol-lowering medications and aspirin, as well as more stress tests, nuclear medicine scans and invasive catheterizations. However, the incidence of heart attacks or cardiac death among people in the study was the same, whether or not patients had a CT angiography test.
"There was no difference in cardiac events at 90 days or at 18 months between the group that had positive findings on the CT angiogram screening compared to the group that did not have the test," says John W. McEvoy, M.B., BCh., BAO, a Johns Hopkins heart specialist and lead author of the study. "Our findings suggest that low-risk patients without symptoms don't benefit in the short term from knowing whether or not plaque has been detected using CT angiography. However, their physicians may be inclined to be more aggressive with prescriptions or follow up tests," McEvoy adds.
For the study, published online in Archives of Internal Medicine on May 23, 2011, researchers compared two similar groups of 1,000 asymptomatic patients who were taking part in a health screening program in South Korea. Patients in one of the groups had coronary CT angiography while a matched control group of 1,000 patients did not have the test. The baseline heart disease risk factors were the same in both groups and none of the patients had chest pain or other symptoms. The mean age of the participants was 50, and 63 percent were men. All were given the standard of care and were advised on ways t
|Contact: Ellen Beth Levitt|
Johns Hopkins Medical Institutions