Clinton Heart Disease Reveals Misconceptions About Testing

Colorado Heart & Body Imaging Says 'Clinton Syndrome' Reveals Limitations

of Stress Tests and Promise of EBT Heart Scans



29 Sep, 2004, 01:00 ET from Colorado Heart & Body Imaging

    DENVER, Sept. 29 /PRNewswire/ -- Sudden, severe cardiac disease or death
 among apparently healthy entertainers, government officials and highly trained
 athletes predictably leaves the public feeling vulnerable to the nation's top
 medical killer, coronary heart disease.
     Dr. James Ehrlich, medical director of Colorado Heart & Body Imaging in
 Denver, said many of the nation's leading cardiac imaging experts are now
 examining the lessons learned from former President Bill Clinton's recent
 heart problems.
     "Widespread managed care indifference and non-coverage of extensively
 validated preventive procedures continues to contribute to the typical (late)
 initial signs of heart disease among most U.S. citizens -- sudden death or an
 irreversible heart attack," said Ehrlich.  "In the matter of Mr. Clinton,
 questions have arisen regarding his cholesterol management and compliance with
 lipid-lowering medications, the failure of stress testing to detect coronary
 disease and the astounding fact that his initial symptom was severe and life-
 threatening, requiring immediate bypass surgery."
     Emerging from the "Clinton Syndrome" is an alarming pattern of physician
 and media misconception about the roles and limitations of various tests to
 diagnose cardiac disease.  Sadly, according to Ehrlich and other prominent
 physicians, the public's interest in prevention and early detection technology
 is being met with a prevalent dismissive attitude from some cardiologists who
 have little experience in coronary prevention.
     Many physicians wonder why an accurate early detection imaging procedure
 (electron beam tomography or EBT) was not made available to Clinton years ago.
     Dr. Harvey Hecht, Director of Preventive Cardiology at NY's Beth Israel
 Hospital, asserted, "There is no doubt that President Clinton would have been
 identified as high risk 10 years ago -- if he had undergone calcium scanning
 -- and the odds are great that bypass surgery could have been avoided."
     Dr. Jeffrey Boone, a consultant in preventive cardiology at Colorado Heart
 & Body Imaging in Denver put it this way:  "Clinton's medical team could have
 known long ago of the presence of his atherosclerotic plaque, determined its
 causation and easily stabilized the plaque with targeted medications.  The EBT
 heart scan is now available for all for a fairly modest price and should have
 been part of the Presidential physical exam for at least the past decade!"
     Stress tests cannot detect early disease, so few cardiologists are
 surprised that Clinton passed treadmill examinations over the years.  As
 stated by Cedar-Sinai's Dr. Daniel Berman, a leading nuclear stress testing
 expert, "There are noninvasive tests that can effectively define the presence
 of coronary artery disease even before a blockage has occurred, such as EBT
 that detects plaque in the coronary artery wall.  In a recent article in the
 Journal of the American College of Cardiology, we found that 56 percent of
 patients who had normal SPECT scans (an accurate nuclear stress test) had a
 coronary calcium scan that revealed enough disease to be predictive of high
 long-term risk for heart attack or death.  We can thereby identify patients
 early for aggressive therapy with diet, exercise, and medications."
     Office-based estimation of coronary risk is being increasingly challenged.
 Ohio State Clinical Professor John Rumberger stated, "whereas Framingham
 models and other formulas work generally well for large populations,
 physicians need to identify individual risk to either offer reassurance or to
 apply effective targeted strategies to prevent coronary disease.  EBT imaging
 is an ideal starting point so we can precisely quantify risk."
     The results of coronary calcium scanning hold the additional promise of
 improved patient compliance with recommended lifestyle modification and
 medications ... an issue for millions, including Clinton, who was not
 convinced of the long-term value of such therapy.
     Compelling research from a group led by UCLA cardiologist Matthew Budoff
 prompted this statement: "Undergoing EBT calcium scanning has been
 demonstrated to dramatically improve compliance with lifestyle (diet and
 exercise), as well as with cholesterol lowering drugs.  In a study of over
 1000 patients followed for 3.6 years, patients with high calcium scores (>75th
 percentile) were 9 times more likely to continue their therapy."
     On a positive note, Ehrlich said the Clinton situation has rekindled
 overall interest in noninvasive preventive coronary imaging to assist in the
 early identification of true 'high-risk' individuals years or decades before
 conventional cardiac testing will be abnormal.
     "Media reports (e.g., NBC's Robert Bazell) stating that CT is 'unreliable'
 and involves 'huge' radiation doses are simply irresponsible.  EBT coronary
 imaging is highly accurate and exposes patients to only a modest fraction of
 background annual radiation exposure."
     Plaque imaging experts anticipate that the upcoming American Heart
 Association statement will result in greater reimbursement and physician
 understanding of coronary imaging.
 
     About Colorado Heart & Body Imaging
     Founded in 1997, Colorado Heart & Body Imaging operates two world-class,
 comprehensive, preventive screening centers in Denver, Colo. at 2490 West 26th
 Avenue #110-A and 201 Columbine Street in Cherry Creek North.  The centers
 offer lung, heart, colon, total body and bone density imaging for early
 detection of coronary disease and cancer as well as non-imaging based services
 and consultation.  CHBI uses FDA-approved electron beam tomography (EBT), with
 its extraordinarily fast acquisition speeds.  Unlike slower and higher
 radiation helical (spiral) mechanical equipment, EBT's usefulness for coronary
 imaging and cardiac risk assessment has been validated extensively in
 cardiology literature.  Formal cardiology relationships have been developed
 with Aurora-Denver Cardiology.  Colorado Imaging Associates continues its
 professional radiologic services for the centers.  For more information,
 contact Colorado Heart & Body Imaging at 303.433.8800 or visit
 www.coloradoheart.com.
 
 

SOURCE Colorado Heart & Body Imaging
    DENVER, Sept. 29 /PRNewswire/ -- Sudden, severe cardiac disease or death
 among apparently healthy entertainers, government officials and highly trained
 athletes predictably leaves the public feeling vulnerable to the nation's top
 medical killer, coronary heart disease.
     Dr. James Ehrlich, medical director of Colorado Heart & Body Imaging in
 Denver, said many of the nation's leading cardiac imaging experts are now
 examining the lessons learned from former President Bill Clinton's recent
 heart problems.
     "Widespread managed care indifference and non-coverage of extensively
 validated preventive procedures continues to contribute to the typical (late)
 initial signs of heart disease among most U.S. citizens -- sudden death or an
 irreversible heart attack," said Ehrlich.  "In the matter of Mr. Clinton,
 questions have arisen regarding his cholesterol management and compliance with
 lipid-lowering medications, the failure of stress testing to detect coronary
 disease and the astounding fact that his initial symptom was severe and life-
 threatening, requiring immediate bypass surgery."
     Emerging from the "Clinton Syndrome" is an alarming pattern of physician
 and media misconception about the roles and limitations of various tests to
 diagnose cardiac disease.  Sadly, according to Ehrlich and other prominent
 physicians, the public's interest in prevention and early detection technology
 is being met with a prevalent dismissive attitude from some cardiologists who
 have little experience in coronary prevention.
     Many physicians wonder why an accurate early detection imaging procedure
 (electron beam tomography or EBT) was not made available to Clinton years ago.
     Dr. Harvey Hecht, Director of Preventive Cardiology at NY's Beth Israel
 Hospital, asserted, "There is no doubt that President Clinton would have been
 identified as high risk 10 years ago -- if he had undergone calcium scanning
 -- and the odds are great that bypass surgery could have been avoided."
     Dr. Jeffrey Boone, a consultant in preventive cardiology at Colorado Heart
 & Body Imaging in Denver put it this way:  "Clinton's medical team could have
 known long ago of the presence of his atherosclerotic plaque, determined its
 causation and easily stabilized the plaque with targeted medications.  The EBT
 heart scan is now available for all for a fairly modest price and should have
 been part of the Presidential physical exam for at least the past decade!"
     Stress tests cannot detect early disease, so few cardiologists are
 surprised that Clinton passed treadmill examinations over the years.  As
 stated by Cedar-Sinai's Dr. Daniel Berman, a leading nuclear stress testing
 expert, "There are noninvasive tests that can effectively define the presence
 of coronary artery disease even before a blockage has occurred, such as EBT
 that detects plaque in the coronary artery wall.  In a recent article in the
 Journal of the American College of Cardiology, we found that 56 percent of
 patients who had normal SPECT scans (an accurate nuclear stress test) had a
 coronary calcium scan that revealed enough disease to be predictive of high
 long-term risk for heart attack or death.  We can thereby identify patients
 early for aggressive therapy with diet, exercise, and medications."
     Office-based estimation of coronary risk is being increasingly challenged.
 Ohio State Clinical Professor John Rumberger stated, "whereas Framingham
 models and other formulas work generally well for large populations,
 physicians need to identify individual risk to either offer reassurance or to
 apply effective targeted strategies to prevent coronary disease.  EBT imaging
 is an ideal starting point so we can precisely quantify risk."
     The results of coronary calcium scanning hold the additional promise of
 improved patient compliance with recommended lifestyle modification and
 medications ... an issue for millions, including Clinton, who was not
 convinced of the long-term value of such therapy.
     Compelling research from a group led by UCLA cardiologist Matthew Budoff
 prompted this statement: "Undergoing EBT calcium scanning has been
 demonstrated to dramatically improve compliance with lifestyle (diet and
 exercise), as well as with cholesterol lowering drugs.  In a study of over
 1000 patients followed for 3.6 years, patients with high calcium scores (>75th
 percentile) were 9 times more likely to continue their therapy."
     On a positive note, Ehrlich said the Clinton situation has rekindled
 overall interest in noninvasive preventive coronary imaging to assist in the
 early identification of true 'high-risk' individuals years or decades before
 conventional cardiac testing will be abnormal.
     "Media reports (e.g., NBC's Robert Bazell) stating that CT is 'unreliable'
 and involves 'huge' radiation doses are simply irresponsible.  EBT coronary
 imaging is highly accurate and exposes patients to only a modest fraction of
 background annual radiation exposure."
     Plaque imaging experts anticipate that the upcoming American Heart
 Association statement will result in greater reimbursement and physician
 understanding of coronary imaging.
 
     About Colorado Heart & Body Imaging
     Founded in 1997, Colorado Heart & Body Imaging operates two world-class,
 comprehensive, preventive screening centers in Denver, Colo. at 2490 West 26th
 Avenue #110-A and 201 Columbine Street in Cherry Creek North.  The centers
 offer lung, heart, colon, total body and bone density imaging for early
 detection of coronary disease and cancer as well as non-imaging based services
 and consultation.  CHBI uses FDA-approved electron beam tomography (EBT), with
 its extraordinarily fast acquisition speeds.  Unlike slower and higher
 radiation helical (spiral) mechanical equipment, EBT's usefulness for coronary
 imaging and cardiac risk assessment has been validated extensively in
 cardiology literature.  Formal cardiology relationships have been developed
 with Aurora-Denver Cardiology.  Colorado Imaging Associates continues its
 professional radiologic services for the centers.  For more information,
 contact Colorado Heart & Body Imaging at 303.433.8800 or visit
 www.coloradoheart.com.
 
 SOURCE  Colorado Heart & Body Imaging