Research Activities, February 2011: Outcomes/Effectiveness Research: Cardiac procedures can lead to substantial radiation exposure for patients

Outcomes/Effectiveness Research
Cardiac procedures can lead to substantial radiation exposure for patients

High amounts of ionizing radiation can increase a person's lifetime cancer risk. Because many cardiac imaging procedures expose patients to radiation, doctors and patients must balance the benefit of those procedures with the risks that come with radiation exposure.

A new study led by Jersey Chen, M.D., M.P.H., of Yale, finds that nearly 1 in 10 adult patients between the ages of 18 and 64 underwent at least one cardiac imaging procedure during a 3-year period. Because of naturally occurring radiation, each year the average person in the United States receives a dose of about 3 millisievert (mSv), the unit of measurement for an effective radiation dose. In contrast, the 90,121 patients in this study who underwent cardiac imaging procedures received an average cumulative effective dose of 23.1 mSv. In fact, 3,173 patients received more than 20 mSv annually, and 75 patients received greater than 50 mSV each year.

The authors calculated the annual population-based rates of getting an effective dose of more than 3 to 20 mSv at 89 per 1,000 and 3.3 per 1,000 for doses greater than 20 mSv. Because 49,478 of the patients who underwent a cardiac imaging procedure were aged 35 to 54, the authors suggest that they and their providers consider alternative procedures, when viable, because these patients are likely to live long enough to develop long-term complications from radiation exposure. They recommend cardiologists become more adept at explaining the possible risks of radiation exposure and be open to alternative procedures, such as stress echocardiography in lieu of myocardial perfusion imaging to examine the blood flow to the heart and heart function. This study was funded in part by the Agency for Healthcare Research and Quality (HS18781).

See "Cumulative exposure to ionizing radiation from diagnostic and therapeutic cardiac imaging procedures: A population-based analysis," by Dr. Chen, Andrew J. Einstein, M.D., Ph.D., Reza Fazel, M.D., M.Sc., and others in the August 24, 2010, Journal of the American College of Cardiology 56(9), pp. 702-711.
Research Activities, February 2011: Outcomes/Effectiveness Research: Cardiac procedures can lead to substantial radiation exposure for patients