Acoustic Imprint of CAD by Acarix
55-year-old patient with recurrent atypical chest pains, on and off for a few weeks. Has several coronary risk factors (HTN, Dyslipidemia and Type 2 DM) and on these medications: Valsartan HCT 160/12.5, Atorvastatin 10 mg and Metformin ER 750 mg Q AM.
EKGs were all normal.
Was referred to the office for evaluation.
Patient was told that the test indicated that there was NO obstructive CAD and the risk of this chest pain leading to an acute heart attack is low (in the short term).
In my practice, I will order a $70 - $100 coronary calcium scoring test for these new patients. Why should every physician do this? Go to www.HeartAttackPreventionChannel.com.
This is an opportunity to stop a heart attack before it happens - to determine if early plaque build-up is present or not, and if present, how much. Current medical therapy may need to be readjusted if not optimal.
Is the change in the dynamic flow characteristics after significant plaque regression or progression detectable by this technology?
Is this test reproducible - if repeated the next day, will you get more or less the same CADScor?
If CACS is zero - no further testing is required. No change in meds.
Whether the CACS is 94 or 746 - Plaque-stabilizing, plaque-regressing medical therapy is needed and meds need readjustment. I probably will order a nuclear stress test if CACS is 746.
Initial fasting lipid profile with medical therapy:
LDLp = 1200 LDLc = 80 HDLc = 45 TGs = 155 T. Chol = 160
BP = 140/85 HgA1c = 7.5 hs-CRP = 1.2
Medical therapy was re-adjusted and 3 months later:
LDLp = 550 LDLc = 42 HDLc = 50 TGs = 100 T.Chol = 110 BP = 125/65 HgA1c = 6.8 hs-CRP = 1.0
I see a potentially broader application of this technology in patients with known CAD by calcium scoring.
My questions regarding the potential use of CADScor in patients with non-zero CACS is for follow up.
1. Can CACScor be used in patients with known CAD to determine plaque progression or stenosis progression - requiring more aggressive medical therapy?
2. Is the CADscor unique for that specific patient at that stage of the disease and can it be used for follow up? In patients who are not compliant with medical therapy, can an increase in CADScor be used to urge or convince patient to quit smoking and take medications regularly, etc.?
If a patient had a CACScor of 40 initially with a CACS of 500 and two years later, the CADScor is 60 - does that mean plaque progression and more stenosis?
Or if the CADScor comes down from 40 to 20 after two years of aggressive medical therapy - does that mean plaque regression and less stenosis?
3. What codes do I use for billing? And give me examples of actual successful reimbursements? Also, give me examples where insurance refused reimbursements - what did you do?
4. Can I get a 50% discount on the monthly lease and the cost of disposable chest adhesive modules for 1 year?
5. Will you help introduce this test to primary care physicians in the area and that we offer this test in our office (in addition to what we will do ourselves - I might create a video later about actual cases)?
You or your manager can call me on Tuesday or Wednesday afternoon.
When a 40 or 50 year old patient comes in for heart attack prevention, the initial evaluation involves clinical cardiology expertise.
After the initial evaluation, preventive cardiology expertise determines how most accurately determine the risk for cardiovascular events within the next 5 to 10 years.
Advanced Lipid Clinic
Once the severity of risk is known, medical therapy is optimized to the level of risk. Advanced lipid therapy is the foundation of prevention in high risk patients.