Heart Disease Lower Than Expected in Europe

Less invasive screenings better fit with lower coronary artery disease rates

(RxWiki News) A new study revealed that the prevalence of heart disease in Europe is lower than expected. This means that more non-invasive screenings could cut costs and help patients avoid unnecessary testing.

In Europe, about 75 percent of the population would benefit from increased non-invasive testing.

In both the U.S. and Europe, many patients with suspected coronary artery disease do not receive initial non-invasive screenings even though less than 40 percent are ultimately diagnosed with coronary disease after invasive testing.

"Always treat chest pain as an emergency."

The EValuation of INtegrated Cardiac Imaging (EVINCI) study coordinator Danilo Neglia, MD, head of the PET and PET-CT Unit at the Institute of Clinical Physiology, National Research Council, in Italy, said it's obvious that there is a need to better select high-risk patients through non-invasive testing to avoid expensive, risky and inappropriate invasive procedures.

“We do actually know the strengths and weaknesses of each technique but there is no clue as to which approach is the most cost effective to solve the diagnostic issue and define proper treatment in the single patient,” Dr. Neglia said.

During the three-year multi-center EVINCI trial, investigators followed 695 patients with chronic chest pain. The participants, between the ages of 30 and 75 and mostly men, had an average coronary artery disease risk of 60 percent.

The participants from 17 European centers first underwent integrated non-invasive testing, mostly based on imaging of the heart. They then received cardiac catheterization, where a catheter is inserted in the groin and threaded through to the heart, if appropriate, to determine the extent of coronary artery disease. Patients were followed for up to three years.

Preliminary study results revealed that among patients with chronic chest pain, the likelihood of significant coronary disease based on clinical and stress ECG evaluation, is largely overstated. As a result, patients may be receiving unnecessary invasive procedures.

While study participants had been estimated to have an average of a 60 percent probability of significant coronary artery disease, heart catheterization confirmed only 25 percent of patients had coronary artery disease.

Investigators are still working to complete a final analysis, but expect to demonstrate that most patients with suspected coronary artery disease could safely avoid invasive diagnostic procedures. Final results are expected in the coming weeks.

“The EVINCI results will probably show that a number of invasive coronary angiography procedures are unnecessary,” says Dr. Neglia. “In these patients a non-invasive diagnostic imaging test can be performed, which would save money and be safer for patients.”

Preliminary results of the study were presented June 26 during the EVINCI Consortium’s final meeting at the University Hospital Ramón y Cajal in Madrid, Spain.

Review Date: 
June 25, 2012