NEW DELHI: Should people suffering from long-term vascular and heart conditions in which there is inadequate blood flow to or from the heart, a condition referred to as Chronic Coronary Disease (CCD), be subjected to regular screening with stress testing or CT scan? The latest guideline by American Heart Association (AHA) advises against it.

The AHA says stress testing or CT scan, the most commonly prescribed tests, is not needed for routine follow-ups if the patient is on guideline-directed therapies and has not had any changes in symptoms of functional status.
The AHA has also recommended against nutrition or dietary supplements — including omega-3 fatty acids, vitamins C, D, or E, beta-carotene or calcium — for people with CCD. “There is not enough evidence showing whether non-prescription nutrition or dietary supplements are beneficial for people with CCD,” the non-profit organisation based in the US has said. Top cardiologists say the AHA guidelines are equally relevant to India.

Unnecessary tests and prescription of medicines that have limited benefits are widely prescribed. This should be reassessed in favour of emerging evidence, doctors say. “While modern imaging modalities are a valuable advancement in cardiac care, there are several harms of indiscriminate universal cardiac imaging. Imaging tests like CT scan or radionuclide test exposes one to radiation. One CT scan is equivalent to getting 400 chest x-rays, thus one must be selective and discerning in using these tools,” Dr Ambuj Roy, professor of cardiology at AIIMS Delhi said.

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