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Newsweek Article-April 6, 1998 By
Geoffrey Cowley
Checking your Vessels-Are you headed for a heart attack despite your low cholesterol? A $400 test makes it easier to find out.
When your cholesterol is in the stratosphere and slicing bread makes your chest ache, you know you have a problem. Unfortunately, arterial disease doesn't always present such clear warnings. For some 150,000 Americans this year, the first and only sign of clogged arteries is a fatal heart attack. Are you headed for trouble despite your seeming good health? A new test- The Ultrafast Ct Scan- could make finding out a lot easier. The new scan can detect heart disease at its earliest and most treatable stages. And because the procedure is quick, cheap and noninvasive, it could become as common as mammography, and equally effective in saving lives.
The surest way to measure arterial blockage is through invasive procedures such as coronary angiography and intravascular ultrasound. But no one would suggest using these tests to screen healthy people. They cost $3,000 to $5,000 and involve threading a catheter from the groin up into the chest to examine the vessels that feed the heart. The new scanning procedure, developed by Imatron Inc. of San Francisco Calif., cost only $350 to $500 and is far less tricky. The patient simply lies on a table for five minutes with a doughnut-shaped scanner surrounding his chest. Like a conventional CT scan, the device uses beams of electrons to create interior images. But because it works seven times faster than a conventional CT scan, the pictures it generates aren't blurred by the motion of the heart and blood. By analyzing images of the coronary arteries, a technician can determine how much calcium they contain-and that score provides a good indication of how badly they're clogged. If the blockage looks severe, a cardiologist will perform the more invasive tests before prescribing angioplasty or bypass surgery. "To pinpoint the blockage, you still need an angiogram," says one specialist. But if the Ultrafast scan reveals, say a 20 percent blockage in a seemingly healthy person, that person can attack the problem-with drugs or through diet and exercise-before it attacks his heart.
Only 40 U.S. clinics currently offer the Ultrafast CT scan, and because it is so new, few insurers cover the cost. But that's likely to change as researchers confirm its diagnostic power. In one ongoing study, doctors at New York's, St Francis Hospital have run the test on 1,172 symptom-free volunteers and follow them for period of three to four years. The latest results to be presented in Atlanta this week at a meeting of the American College of Cardiology, suggest that the Ultrafast CT scan gauges heart-attack risk 10 times more reliably than a cholesterol test. " The accuracy is unprecedented," says Dr. Alan Guerci, director of research at St. Francis. "Our findings suggest this could become the primary screening tool for coronary artery disease."
Mass screening of healthy adults would be a costly proposition, even at $400 a head. But if people acted on the results, the effort could be well worth the money.