Association for Eradication of Heart Attack Helps Texas Representative René Oliveira Introduce the First Atherosclerosis Screening Reimbursement Bill
Groundbreaking screening legislation could prevent 4,300 sudden cardiac deaths and save $1.6 billion per year in Texas
Rep. Oliveira’s bill is the first legislative effort in the United States to encourage the careful and responsible implementation of a comprehensive heart attack risk assessment and reduction strategy. It closely follows the SHAPE (Screening for Heart Attack Prevention and Education) Guidelines for identification of apparently healthy individuals who are at risk of a near future heart attack. The guideline was developed by the SHAPE Task Force, an international contingent of leading cardiologists and researchers organized by the AEHA.
Almost all heart attacks are preceded by atherosclerosis (plaque buildup in the arteries). Despite the availability of non-invasive imaging tests that can detect the presence of atherosclerosis and measure its severity, many physicians continue to rely solely upon screening for traditional risk factors of atherosclerosis.
“Traditional risk factors such as high cholesterol and high blood pressure are grossly inaccurate for identifying asymptomatic patients who suffer from severe atherosclerosis and are in urgent need of treatment,” said Dr. P.K. Shah, a leading member of the SHAPE Task Force and American Heart Association. “Sadly, these vulnerable patients go undetected because insurance companies don’t cover the newer heart attack screening methods.”
Rep. Oliveira discovered this problem when his insurer initially refused to cover the heart scan that discovered plaque buildup and prompted a heart bypass operation.
“It is about time that we cover preventive screening for the number one killer in Texas, and take action to reduce healthcare costs through preventive healthcare,” said Representative Oliveira, a Democrat from Brownsville, Texas. “Right now, we are extending the lives of those who can afford the procedure while hundreds of thousands of cases of heart disease in Texas go undetected because of antiquated thinking. The time has come for this change.”
Rep. Oliveira’s bill would apply to men between ages 45 and 75, and women between ages 55 and 75, who are at intermediate or high risk of a heart attack according to their Framingham Risk Score. The bill would require reimbursement for two types of procedures: 1) the measurement of coronary artery calcium score (CACS) by CT and 2) the measurement of carotid intima-media thickness (CIMT) and plaque by ultrasonography.
“At one time, using imaging technologies to look inside the body and screen for cancer seemed like an impractical idea, but requiring reimbursement has made it part of everyday medicine and has saved countless lives,” said Dr. Morteza Naghavi, chairman of the SHAPE Task Force who founded AEHA to focus on the eradication of heart attacks. “If this legislation passes, we anticipate that tens of thousands of Texans who are completely unaware of their severe disease can be detected and saved from a catastrophic heart attack by getting into intensive treatment.”
Heart attack and stroke account for more death and disability than all cancers combined and, unlike cancers, heart attack strikes more than half of its victims by sudden death, leaving no opportunity for treatment. Multiple screening tests are approved for subclinical (asymptomatic) cancers such as mammography and colonoscopy. However, none is approved for subclinical atherosclerosis, which underlies both heart attack and stroke. This void leaves many individuals – even those with severe atherosclerosis – totally unaware of their risk because they have no symptoms.
An analysis by the AEHA estimates that proper screening of these asymptomatic men and women could have the following outcomes:
- Prevent more than 4,300 deaths from cardiovascular disease each year in Texas (over 90,000 deaths in the U.S.).
- Reduce the Texas population with a history of heart attack – currently estimated to be 550,000 – by as much as 25 percent.
- Save approximately $1.65 billion annually (over 21 billion in the U.S.).
“We are very thankful for Representative Oliveira’s strong leadership in working to correct a profound failure of our healthcare system,” said Dr. Matthew Budoff, a member of the SHAPE Task Force who is the leading author of the latest scientific statement of American Heart Association regarding noninvasive cardiac CT imaging. “These technologies are widely available, but because insurance doesn’t cover them, only people with the means to pay for the procedures out of their own pockets can benefit from these advances. If passed, this bill will have a monumental impact on preventive cardiovascular healthcare that can go far beyond Texas.”
Atherosclerosis, a metabolic and inflammatory disease that causes plaque build up in arteries, is responsible for nearly all cases of heart attack and most cases of strokes. Individuals with the highest degree of atherosclerotic plaque burden are described as “the Vulnerable Patient.” Such individuals exhibit no signs of heart disease and are not identified as very-high-risk by traditional risk factor assessment. Representative Oliveira’s bill is designed to identify this population and get them the treatment needed to extend their lives.
Editor’s Note: A news conference to announce the bill is scheduled for 9 a.m., Feb. 14, 2007, in the Speaker''s Press Room at the Texas Capitol with Rep. Oliveira, Dr. Naghavi and others.
Originated from the Texas Medical Center in Houston, the AEHA is a non-profit organization that promotes education and research related to mechanism, prevention, detection and treatment of heart attacks. The organization is committed to raising public awareness about recent revolutionary discoveries that opened exciting new avenues to prevent heart attack. The AEHA''s mission is to eradicate heart attacks before the end of the century. Additional information is available on the organization''s Web site at www.aeha.org or call 1-877-SHAPE11
About SHAPE Task Force
Chairman: Morteza Naghavi, M.D. Editorial Committee: Prediman K. Shah, M.D. (Chief); (alphabetic order): Raymond Bahr, M.D., Daniel Berman, M.D., Roger Blumenthal, M.D., Matthew J. Budoff, M.D., Jay Cohn, M.D., Erling Falk, M.D., Ph.D., Ole Faergeman, M.D., Zahi Fayad, Ph.D., Harvey S. Hecht, M.D., Michael J Jamieson, M.D., Wolfgang Koenig, M.D., Ph.D., Daniel Lane, M.D., Ph.D., Morteza Naghavi, M.D., John Rumberger, M.D., Ph.D., Allen J. Taylor, M.D. Writing Group: Erling Falk, M.D., Ph.D. (Coordinator); (alphabetic order): Juhani Airaksinen, M.D., Dan Arking, Ph.D., Juan Badimon, Ph.D., Raymond Bahr, M.D., Daniel Berman, M.D., Matthew J. Budoff, M.D., Jay Cohn, M.D., Jasenka Demirovic, M.D., Ph.D., George A. Diamond, M.D., Pamela Douglas, M.D., Ole Faergeman, M.D., Zahi Fayad, Ph.D., James A. Goldstein, M.D., Harvey S. Hecht, M.D., Victoria L.M. Herrera, M.D., Michael J Jamieson, M.D., Sanjay Kaul, M.D., M.P.H., Wolfgang Koenig, M.D., Ph.D., Robert A. Mendes, M.D., Morteza Naghavi, M.D.; Tasneem Z. Naqvi, M.D., Ward A. Riley, Ph.D., Yoram Rudy, PhD, John Rumberger, M.D., Ph.D., Leslee Shaw, Ph.D., Robert S. Schwartz, M.D., Arturo G. Touchard, M.D. Advisors (alphabetic order): Arthur Agagston, M.D., Stephane Carlier, M.D., Ph.D., Raimund Erbel, M.D., Chris deKorte, Ph.D., Craig Hartley, Ph.D., Ioannis Kakadiaris, Ph.D., Roxana Mehran, M.D., Ralph Metcalfe, Ph.D., Daniel O''Leary, M.D., Jan Nilsson, M.D., Gerard Pasterkamp, M.D., Ph.D., Paul Schoenhagen, M.D., Henrik Sillesen, M.D., Ph.D.