Heart Attack Tests for All?
Group of Prominent Cardiologists Calls for Radical Change in Testing for Heart Risk
WebMD News Archive
Do Guidelines Promise Too Much, Too Soon?
The SHAPE guidelines appear in the July 10 issue of the American Journal
of Cardiology. The authors include a long list of prominent heart
But some other prominent specialists aren't signing on, arguing the
technology can not yet do what the AEHA group suggests. One is Eric J. Topol,
MD, professor of genetics at Cleveland's Case Western Reserve University, and
one of the world's 10 most-cited biomedical researchers.
"This organization is taking a very aggressive approach," Topol
says. "It says we are ready to screen the arteries directly," he tells
WebMD. "They want to noninvasively detect plaques days, weeks, or months
before they will cause trouble. But no technique can do this. They are not even
"Many years from now this may be possible. But we are not there
yet," says Topol.
No Change in Official Guidelines
The SHAPE recommendations won't change official U.S. guidelines, says Diane
Bild, MD, deputy director of the division of epidemiology and clinical
applications at the National Heart, Lung, and Blood Institute of the National
Institutes of Health, Bethesda, Md.
"What we really need for [federal] guideline recommendations is just not
available yet," Bild tells WebMD. "This is a laudable effort to move
preventive cardiology forward. But it occurs with a lack of the complete and
clear information that we need to make guidelines.
"The tests are out there. They are being used," Bild says. "It
is just not clear what the value of these tests really is -- and whether
treatment should be targeted based on those tests."
Naghavi bristles at the argument that the screening tests aren't ready for
Tests Uncover Major Risks
"To those who say the technology isn't there yet, we say check with
recent discoveries," Naghavi says.
"For the very first time in heart medicine, we now have a test that can
show someone has up to a 65-fold increased risk of a heart
attack," he says. "With the traditional risk factors, the
biggest risk is high cholesterol, which has only up to 4.5-fold
increased risk. So you can see how much of a jump in prediction we get from