CT scans are faster in ruling out heart attacks: research

About 6 million people each year go to hospitals with chest pain, but only a small fraction are truly having a heart attack. CT scans are increasingly used to diagnose problems because they give a deep, detailed view inside the body. But they put out a lot of radiation, which may raise a person's chances of developing cancer. Whether these scans are worth that risk is unknown. The new study suggests that for ruling out heart attacks in the emergency room, they just might be. The research involved 749 chest pain sufferers at 16 big medical centers around the country. These were people who did not have clear signs of a heart attack from blood tests or EKGs, but doctors are afraid to send them home without more tests.

Between 4 percent and 13 percent of such patients will have a missed diagnosis of a heart attack, and up to one quarter of that group will die, said the new study's leader, Dr. Kavitha Chinnaiyan, a cardiologist at William Beaumont Hospital in suburban Detroit. In the study, half of the patients were given CT scans and the rest, standard imaging tests with a radioactive dye. Of the CT patients, 82 percent were found to have clear arteries and were discharged immediately. In the other group, 89 percent were determined to have normal arteries and sent home.

The portion of patients who needed a definitive but invasive test — angiography — to see whether they should have an artery-opening balloon angioplasty procedure or bypass operation was the same — 6 to 7 percent of each group.

The big difference was in cost and time. CT scan patients were diagnosed in about three hours versus more than six for the others. Their testing also cost less — US$2,137 on average versus US$3,458 for standard screening. The study had partial support from Bayer Pharmaceuticals. A few doctors involved in the study have had research grants from Bayer or a firm that makes imaging equipment.

Radiation remains a concern, though. A CT scan of the chest involves 10 to 15 millisieverts (a measure of dose) versus 0.01 to 0.15 for a regular chest X-ray, 3 for a mammogram and a mere 0.005 for a dental X-ray.

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