Elective cardiac catherization

Low Diagnostic Yield of Elective Coronary Angiography (From: Manesh R. Patel, M.D.,et al.,N Engl J Med 362;10, 886-895)

"...slightly more than one third of patients without known disease who underwent elective cardiac catheterization had obstructive coronary artery disease..."

The authors analyzed data from a national registry on cardiac catheterization, reporting only 38% of elective, diagnostic coronary angiograms showed obstructive lesions, and 39% of angiograms were interpreted as showing no disease. The findings indicate a relatively low diagnostic yield of elective coronary angiography, a procedure that exposes patients to substantial radiation.

Remarks:

The results indicate that elective cardiac catherization is a poor tool as an initial screening test. Since other, less invasive and expensive tests are available, one wonders what prompted unnecessary cathetrization in over 60% of the patients studied in this paper.