Saturday, August 20, 2011

Dr. Steven Nissen: "Calcium Scanning Is One Of The Worst Examples Of Medicine Gone Wild"

Odd. This ABC news piece said:
"50% of people who have heart attacks have normal cholesterol."
So if cholesterol isn't a good indicator of heart attack, what is? Looking at blood levels of C-reactive protein (CRP), a marker for inflammation (but you can't tell where), was supposed to help. But a new study in the journal Lancet found that having a CT scan to view calcium build-up in arteries was better than CRP testing.

Here's the odd part. If the test shows calcium in arteries, the therapy is to give statins. Statins lower production of cholesterol, and right up front they said that half of people who have heart attacks have normal cholesterol.

Scans may be quick and painless as the article said, but they are not cheap, and they are not without risk. There is no level of radiation that is risk-free. People who have diminished ability to repair DNA are at significantly higher risk of cancer from these procedures.

They also may not work:
"For many, calcium presence in the arteries does not necessarily indicate heart disease or even a looming heart attack. Studies have yet to show that calcium scans have reduced the risk of heart attack or death from heart disease."
Dr. Steven Nissen, chair of cardiovascular medicine at Cleveland Clinic, said:
"Calcium scanning is one of the worst examples of medicine gone wild. It's taken on a 'cultlike' following."
Dr. Howard Weintraub, clinical director of New York University Center for Prevention of Cardiovascular Disease, said:
"This test has led many to perform more invasive tests and then potentially act on its findings. Even though in the vast majority the intervention will do nothing to prevent [heart attack] or death and, in the absence of pre-existing symptoms, won't improve quality of life."
This is how spending on healthcare is going through the roof ... without concomitant improvement in health. This is why we need comparative effectiveness research.
________
Photo is of CNN's Dr. Sanjay Gupta undergoing a heart scan.

16 comments:

Dr. Mel said...

It's vary profitable for the hospitals. As well, technicians who work in scanning and/or nuclear-medicine facilities have higher cancer rates than other hospital workers.

Laurie Endicott Thomas said...

It's extremely misleading for them to say that 50% of the people who get heart attacks have "normal" cholesterol. The values that are "normal" in the United States are unhealthy. Healthy cholesterol levels are so low that they are abnormal in the United States.
http://wheredogorillasgettheirprotein.blogspot.com/2011/03/weight-and-cholesterol-when-average-is.html

Here's an explanation of how the levels of "good" and "bad" cholesterol are related to heart disease risk: http://wheredogorillasgettheirprotein.blogspot.com/2011/07/how-low-should-your-cholesterol-levels.html

Bix said...

They kept saying that a normal cholesterol was under 200 mg/dl, for total cholesterol. That's high. I mean, they even inferred that anything under 200 was "low."

Bix said...

Dr. Sanjay Gupta will be interviewing President Bill Clinton tomorrow about his low-fat vegan diet and how it has improved his health. I'm looking forward.

Shreela said...

Dr. William Davis's site has so many posts about heart scans that I can't find the ones where he discussed how he wasn't pleased with many heart scan facilities.

About 2-3 months ago, I read a news article about heart scans, and how many HS centers are heavily promoting their scans. To me, it sounded almost like telemarketer-level pushiness. I think it's a shame, because there seems to be valuable info in the scans done properly. But for-profit centers invest heavily in the latest buzz-words, then have to recoop their investment, regardless of whether the technology they invested in produced anything valuable to heart specialists.

Dr. Davis has been into glycation recently - meanwhile I see many burnt food (IMO) photos coming through my foodie streams.

Bix said...

"...meanwhile I see many burnt food (IMO) photos coming through my foodie streams."

Shreela, I laughed! It's true!

Dr. Mel said...

Do you know where/when Gupta's interview w/ Clinton is?

Bix said...

Melinda, this link:

http://thechart.blogs.cnn.com/2011/08/18/study-to-predict-heart-attacks-use-images/

... says his interview will be broadcast Sunday night. I hope there's a YouTube or something I can embed.

Bix said...

I was reading the comments under that link. There was a man who had shortness of breath. His doc told him it was from being overweight. He later had a triple bypass and 2 stents, and said:

"My heart disease is genetic. I was on a statin and my cholesterol levels were normal. My weight is not caused by overeating. I consume less than 1200 calories per day and avoid fried fatty foods. I also walk 3 miles every other day."

I don't know ...

Dr. Mel said...

If what that guy says is true, that would be a real bummer.
Bix, thanks for the link to the Gupta show--on CNN tonight at 8:00pm, ET.

Dr. Mel said...

Laurie, I've been enjoying looking at your blog on veganism. I would like to be a vegan, but the one thing I haven't been able to give up is really good cheese. Can easily do without meat, eggs, milk, yogurt, etc. All things but cheese. But your blog is fascinating (and inspiring).

Dr. Mel said...

Did I say thanks for the link Bix? Thanks for the CNN link!

Dr. Mel said...

Well, it looks like the Libyan news has superseded the Sanjay Gupta special on heart disease, at least now at 8:05 pm ET.

Bix said...

I'll see what I can find...

I am curious how he eats. I think that veganism - the elimination of all dairy, eggs, poultry, meat, fish, etc. - is extreme and not suited to every person's needs.

Bix said...

From Gupta's Twitter:

@sanjayguptaCNN
Dr. Sanjay Gupta
sorry to say: "the last heart attack" will not air tonight/8p. breaking news in libya. look for the special next weekend.

Bix said...

I hope he doesn't promote heart scans. It's non-evidence-based medicine right now.