New Heart Scan Not All It's Cracked Up to Be, Experts Say
June 30, 2000 -- Consumers who fear heart disease have been paying $600, $800, or more out-of-pocket for a widely advertised test that usually doesn't give their doctors any new information and may actually overstate their risk of heart disease.
Electron-beam computed tomography (EBCT), a specialized scan of the heart, detects calcium deposits in the blood vessels. "This test has been publicized to consumers as the way to find out if you have heart disease, but it really can't do that," says Robert Cleary, MD. "Patients come to me who've seen the ads, paid their money, gotten the test, and now have second thoughts about it. I tell them this test's ability to predict heart disease is no better than widely used tests that are covered by insurance, such as the stress test." Cleary is an interventional coronary and peripheral cardiologist at St. John Hospital and Medical Center in Detroit.
Responding to this situation, the American College of Cardiology and the American Heart Association have just issued an expert consensus statement that summarizes current knowledge about the electron scan technology. A committee of experts representing many viewpoints drafted the statement after a thorough review of the scientific literature on the subject.
Among their conclusions:
- Currently there is not enough compelling evidence to warrant widespread use of EBCT, also called an ultrafast CT scan, in the general population.
- EBCT might be valuable in determining whether a patient who is considered at intermediaterisk for heart disease is actually at high risk for the disease.
- EBCT should not be recommended for patients with no symptoms or for those who do not have multiple risk factors such as high cholesterol, high blood pressure, smoking, and a family history of heart disease.
- To be used in patients with no symptoms, EBCT should be part of an overall medical assessment only after standard test results are insufficient.
"Consumers need to understand there is disagreement among the scientific community about which patients should have this study done," says Robert A. O'Rourke, MD, FACC. "There is little proof it gives you any more information about your risk of heart disease than you already have by looking at well-known risk factors such as cholesterol levels, high blood pressure, and smoking." O'Rourke, who chaired the consensus statement writing group, is the Charles Conrad Brown distinguished professor of cardiovascular diseases at the University of Texas Health Science Center in San Antonio.