For heart disease diagnosis, two tests may be better than one

A U.K. study knocks the use of an angiogram on its own to diagnose and treat heart disease patients, blaming it for flawed results in at least 25% of all cases. Teaming it with a second diagnostic known as a fractional flow reserve could eliminate the problem, however, the trial finding concludes.

The Independent reports on the study by cardiologist Nick Curzen at Southampton General Hospital, who drew his conclusion based on evaluation of 200 angina patients at 10 U.K. sites. And he is calling for a far larger, randomized trial to back up his assessment, one that would compare angiography and fractional flow reserve pressure tests in the management of patients with stable angina. Right now, Curzen told the London newspaper he and colleagues are designing the larger trial and seeking funding.

What he found in his initial evaluation: An angiogram (an X-ray test that uses fluoroscopy) left over 25% of patients with stable heart disease at risk of getting a treatment plan that wasn't appropriate for their condition. This was based on an initial assessment, after which the treatment plan changed when a cardiologist relied on a fractional flow reserve pressure test to gain a second look. For almost a third of vessels analyzed, the added test helped change cardiologists' mind about whether the patient's coronary arteries faced significant narrowing, the story explains.

On the surface, an added diagnostic test for patients suffering from angina may be a hard sell, because of the added cost. But if it helps heart disease patients gain proper treatment earlier in the diagnostic evaluation, expect researchers to make the counterargument that two tests are better than one, because quicker, more accurate treatment could improve outcomes, which itself can be a cost-effective result.

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