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Seven in ten
patients who need test for early stage heart
disease do not receive one
Newswise — Seven in ten patients who have suspected angina
are not given appropriate testing and are
more likely to suffer from serious heart
problems as a result, according to a study
published on bmj.com today.
Women, older people, patients from ethnic minorities and the
poor are the most likely to miss out on
testing.
The researchers, led by Professor Gene Feder from the
University of Bristol, decided to look into
whether patients had equal access to
coronary angiography (a specialist x-ray
examination in which a contrast agent is
injected into the aterieries around the
heart to show the extent and severity of the
narrowing of the arteries around the heart).
They wanted to find out if not having an angiography in the
early stages of heart disease, when a person
presents with suspected stable angina (pains
in the chest after exertion), has a long
term impact on patients’ health.
The researchers studied 10 634 patients with suspected stable
angina attending six chest pain clinics in
England, between January 1996 and December
2002. The sample included white and south
Asian patients with chest pain and no known
coronary heart disease.
An independent panel of doctors found that 1 375 of these
patients needed an angiography.
Each patient was followed up three years later to find how
and if heart disease had progressed, for
example whether they had developed unstable
angina, or suffered a heart attack or other
heart related problems.
They found that overall 69% of patients deemed appropriate
for angiography had not had one. In
addition, people over 65, women, south Asian
patients, and those in the most deprived
fifth of the population were less likely to
receive the test compared with those aged
under fifty, men, white patients, and those
living in the less deprived areas,
respectively.
Importantly, deaths from heart disease and admissions for
heart attacks and unstable angina were more
common in the group who had not had an
angiography.
The researchers do not know the reasons for this and say that
there could be a number of possible
explanations. For example, the variation
could occur because of different referral
methods or because some patients may choose
not to undergo the procedure.
They conclude that further research is needed to support
doctors in improving their decisions about
further investigation of patients with new
angina.
Click here to view full article:
http://press.psprings.co.uk/bmj/april/angina.pdf
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