Word: cholesterol
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What that means is that millions of patients will probably get the treatment that better matches their condition. Some doctors are already starting to use the scans to figure out which of their otherwise healthy-seeming patients need to be taking cholesterol-lowering drugs like statins, and may even be able to decide what to do in marginal cases without having to resort to an invasive angiogram. Patients with a clean scan, on the other hand, can feel confident that they don't need statins or other medication, along with their potential side effects...
...however, that they can take a lot of the guesswork out of diagnosing heart disease. "There's a fairly large middle category of people where it's not clear how much heart disease they actually have," says Dr. David Bluemke at the Johns Hopkins Hospital in Baltimore, Md. "Their cholesterol is high. Their blood pressure is high. They have a few risk factors. That doesn't mean they need to go to the catheterization lab. But it sure would be nice to get a quantitative measure of their disease...
...other hand, there is a lot of evidence that lowering cholesterol levels in those patients with moderate arterial blockage greatly reduces the risk of suffering a heart attack or stroke. So a growing number of cardiologists are using the new cardiac scans to determine which of their otherwise asymptomatic patients need more intense medical treatment with statins and other drugs. "It's the perfect setup," says Dr. Christopher Cannon, a cardiologist at the Brigham and Women's Hospital in Boston. "You don't want to wait until you've had a heart attack to manage your cholesterol...
...surprisingly then, the new cardiac scans are helping to fuel a more aggressive focus on prevention. If a cardiac scan shows your doctor that you have mild coronary artery disease, then, in addition to trying to get your LDL cholesterol level under 70 mg/dL, he or she is probably going to put you on a daily aspirin regimen and make sure your blood pressure is nice and low. "Conversely," says Cannon, "if you have a scan and you're normal, you don't have to start taking five different medications...
First it was blood cholesterol that could give you an early warning that a heart attack might be around the corner. Then came c-reactive protein. And now that doctors can get a better look at what's inside your heart arteries, they are taking a new interest in something they have always known was present in problem vessels: calcium. Hospitals, clinics and even gyms are touting quick and easy scans that can measure the amount of calcium in your coronary arteries in minutes. But while calcium scores can be helpful, doctors caution that using them to predict...