A new study shows that using CT scans of coronary arteries may be may be worth the costs and potential risks in men, but doesn’t seem to be cost-effective in women. Therefore, the thing is Coronary calcium tests itself not always worthwhile and the best choice for predicting the heart attack risk.
CT scans of coronary arteries is one of the method to help determine a person’s chance of getting heart disease. It is now considered in comparison between the benefits and side effects with the other ways to treat people thought to be at moderate risk for heart disease.
Doctors will test how much build-up there is in the blood vessels leading to the heart through a CT scan of coronary calcium. The more build-up raises. The higher risk a person likely get heart disease. Against, little build-up means the risk of disease is low.
From the results, people will be warned to take or not take drugs to lower cholesterol and blood pressure.
Traditionally, all the hypothetical patients considered in the computer analysis were assumed to have a moderate risk of heart disease basing on cholesterol, blood pressure, gender and age. On average, they were older than 69.
If one person is at risk of moderate, or intermediate heart attack, he or she has a 10 to 20 percent chance having a heart stroke or other heart-related “event” in the next decade.
Researchers looked at four different scenarios, namely, treating patients without any special heart-related interventions, giving patients healthy lifestyle advice and putting those with high cholesterol or blood pressure on medication, having every patient take a cholesterol-lowering statin drug or using coronary calcium screening to better estimate heart risks and decide who needs extra treatment.
From these four scenarios, they will consider for each the chances that patients would have a stroke or heart attack along with the costs of appointments, procedures and drugs and the possible risks and side effects associated with the treatments themselves.
Once all of the measurements were done, coronary calcium screening was the most beneficial and also the most expensive option in men. Researchers estimated that approximately $49,000 would have to be used on examining and associated treatment to get a man one extra year in excellent health.
On the other hand, next current recommendations that recommend giving lifestyle advice to all moderate-risk women and drugs to those who need them would be more effective than coronary CT scans and cost a similar amount, the researchers reported in the Journal of the American College of Cardiology.
CT scans for coronary calcium may cost anywhere from $50 to $600, researchers said, and in most cases aren’t covered by insurance.
“You want to comprehend beforehand whether performing such a (test) is worth the risk and the cost,” said Dr. Myriam Hunink, from Erasmus Medical Center in Rotterdam, The Netherlands, who worked on the study.
Those potential risks consist of additional rays from CT scans and also the chance of having an “incidental finding,” something which wouldn’t have caused a patient harm but demands more procedures and examining — with potential unwanted side effects — to check out.
“The bottom line is there’s still a lot of uncertainty,” she told Reuters Health. “It’s possibly cost-effective in men, but it’s unlikely to be cost-effective in women,” although the data in men is still unsure, she said.
The study didn’t check out any other potential tests, such as blood tests to detect marks of inflammation, which could also help doctors more accurately estimate heart disease risk.
Researchers agreed that due to the inconclusive findings, carefully-conducted studies done in people are needed to see how cost-effective coronary calcium screening is in reality.
“All a model similar to this does is tell us it might be worthwhile doing, but… it still looks like it’s a pretty expensive endeavor,” O’Malley told Reuters Health.
Leslee Shaw, who studies risk detection at Emory University in Atlanta, said there’s evidence showing that coronary calcium screening does help determine a patient’s likelihood of getting heart disease. But she said it was “disappointing” that the current study didn’t always find it to be cost-effective.
She said some patients may want to discuss the test with their doctors, but researchers emphasized that it’s not helpful or worth the risks in all people.
“You only limit coronary calcium (screening) to people who have a few risk factors,” such as high cholesterol, diabetes or a family history of heart disease, Shaw told Reuters Health. “You wouldn’t just go out and massively screen everyone.”