This tool scores calcification for AMI
September 1, 1998 2 minutes read
This tool scores calcification for AMI
EBCT pricey but 10 times as accurate as others
Another way of approaching acute myocardial infarction (AMI) diagnosis is with an emerging technology, electron beam computed tomography (EBCT), which looks at the amount of calcification in coronary arteries. Coronary calcium scores are directly related to adverse incidents - the higher the score, the greater the likelihood of cardiovascular events.
The EBCT scan is not for every facility; it's pricey and many payers won't reimburse for it, especially when it's used for screening. An EBCT scan can cost the patient a total of $395 and takes about five minutes to complete. By contrast, an angiogram can cost from $3,000 to $5,000 depending upon conditions, and an exercise EKG takes 5 to 12 minutes to complete, costs up to $400, and detects only about 70% of patients with heart disease. The rub? EBCT requires a capital outlay of $1.6 to $1.9 million, and reimbursement can be dicey.
EBCT scanning, sometimes dubbed 'heart mammography,' was featured in several studies presented at the American College of Cardiology meeting in Atlanta last spring. One, from St. Francis Hospital in Roslyn, NY, demonstrated that calcium scores from Ultrafast CT, manufactured by Imatron in Los Angeles, are "10 times more accurate in predicting those at risk for cardiovascular events than any single risk factor and significantly more accurate than assessment based on cholesterol levels and nonlipid risk factors." The outcomes study scanned more than 1,000 initially asymptomatic patients for heart disease, then obtained follow-up data for three to four years.
A second study came out of Baylor College of Medicine in Houston, and demonstrated that 94% of patients experiencing a first heart attack had coronary artery calcification that could have been detected earlier using EBCT scanning. A majority of those patients had relatively low calcium scores, suggesting that the condition probably would not have been detected by other tests such as treadmills or stress nuclear testing.
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