Patients at high risk for heart disease may often be undertreated, according to a report from Brigham & Women's Hospital in Boston that was published in the Jan. 31st issue of the "Journal of the American College of Cardiology." Even when the results of scans and tests such as SPECT, PET, or CT angiography (CTA) showed significant abnormalities, as many as 61% of the patients were not given a referral for catheterization, almost one-third were not getting aspirin, up to 44% were not put on a beta-blocker, and a quarter were not getting a lipid-lowering agent. These figures were based on a 90-day follow-up.
The researchers wrote: "In light of the costs associated with cardiovascular imaging, it is problematic to justify the use of testing that will not be incorporated into subsequent patient care. A noninvasive procedure, the results of which have no impact on subsequent management, must be considered an inappropriate study; the current study suggests that a significant amount of inappropriate noninvasive procedures are currently performed."
However, data published last August in the JACC found that coronary artery disease seen on CTA was associated with a higher risk of death. The researchers of the current study recommend that CTA could be used to help develop criteria for appropriate use.
