Cardiac Catheterizations: Too Many Performed?
Study Shows Many Patients Who Have the Procedure Don't Have Blocked Arteries
March 10, 2010 -- A large percentage of patients without known heart disease who undergo invasive cardiac catheterization to check for dangerous artery blockages do not have them, a new study suggests.
Duke University Medical Center researchers found that almost two-thirds of patients with stable chest pain who had catheterization procedures did not have significant artery disease.
The study did not include patients who were having heart attacks or those with a prior diagnosis of heart disease or unstable angina.
More than 10 million Americans experience chest pain each year and many have not been diagnosed with heart disease.
Cardiac catheterization is commonly performed in an effort to determine the cause of the pain, but the findings suggest a need for better ways to identify which of these patients will benefit from the invasive procedure, Duke University Medical Center cardiology professor Pamela S. Douglas, MD, tells WebMD.
The study appears in the March 11 issue of the New England Journal of Medicine.
"We want to be clear that if someone is having a heart attack and their doctor sends them to a cath lab, they shouldn't argue," she says. "But a stable patient who has not been diagnosed with heart disease and who does not need catheterization for pain control may want to ask about the risks and benefits."
How Cardiac Catheterizations Work
Cardiac catheterization is performed to examine how well the heart and arteries are functioning. A thin plastic tube, or catheter, is inserted into a blood vessel in the arm or leg and the tube is then guided into the coronary arteries or the heart.
When dye is injected through the catheter into the coronary arteries to check for blockages, the procedure is known as coronary angiography.
In the newly published study, the researchers used a national cardiology registry to identify 2 million people who had cardiac catheterization at 663 hospitals across the U.S. between January 2004 and April 2008.
They determined that roughly 400,000 of these people, or one in five, had stable chest pain without a previous diagnosis of heart disease.