Cardiac catheterization revisions urged

DURHAM, N.C., March 11 (UPI) -- Some U.S. cardiologists say it is time to revise the criteria used to select patients for cardiac catheterization.

The Duke University Medical Center investigators, led by Dr. Manesh Patel, said their study determined the invasive procedure finds no significant coronary artery disease in nearly 60 percent of chest-pain patients with no prior heart disease.

The researchers said more than 10 million people experience chest pain each year and many undergo cardiac catheterization, which is the U.S. standard care for people who experience heart attack or unstable chest pain. The procedure allows doctors to confirm the presence, location and severity of coronary atherosclerosis.

"We're spending a lot of energy and money to evaluate chest pain which often leads to cardiac catheterization, which, we now know, often finds that patients don't have significant obstructive disease," Patel said.

What is needed, he said, is a re-evaluation of the entire decision-making process of caring for patients with chest pain, including how patients' histories are taken, how risk factors are assessed and the role of diagnostic testing.

The research appears in the New England Journal of Medicine.