A study in the New England Journal of Medicine calls into question something that has become standard practice--that of sending patients with chest pain to have a cardiac catheterization or angiogram. In the study, slightly more than a third of patients were found to have obstructive coronary disease.
"What this says is that we need to re-evaluate how we work these patients up from start to finish," Dr. Manesh Patel told HealthDay. Patel, assistant professor of medicine at Duke University, is lead author of the report in the March 11 issue.
He and his team included 398,978 patients from 663 hospitals between 2004 and 2008. Of those who underwent the testing--in which a long, thin, flexible catheter is inserted into a blood vessel in your arm, groin or neck and threaded into your heart--obstructions were found in 37 percent of patients. Thirty-nine percent were found not to have obstructive disease.
Patel writes in his conclusion that "better strategies for risk stratification are needed to inform decisions and to increase the diagnostic yield of cardiac catheterization in routine clinical practice."
"What this says is that we need to re-evaluate how we work these patients up from start to finish," Dr. Manesh Patel told HealthDay. Patel, assistant professor of medicine at Duke University, is lead author of the report in the March 11 issue.
He and his team included 398,978 patients from 663 hospitals between 2004 and 2008. Of those who underwent the testing--in which a long, thin, flexible catheter is inserted into a blood vessel in your arm, groin or neck and threaded into your heart--obstructions were found in 37 percent of patients. Thirty-nine percent were found not to have obstructive disease.
Patel writes in his conclusion that "better strategies for risk stratification are needed to inform decisions and to increase the diagnostic yield of cardiac catheterization in routine clinical practice."
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