IS POPULARIZATION OF CORONARY ANGIOGRAPHY BENEFICIAL TO PATIENTS WITH CORONARY HEART-DISEASE

During the last ten years there has been a dramatic increase in the use of coronary arteriography, a procedure currently deemed useful or indispensable at all the stages of coronary heart disease. However, despite improvements in catheter technology and angiography equipment, coronary arteriography is still not a completely safe procedure : even in well experienced hands, it is responsible for morbidity and mortality, for exposure of patients and health care providers to radiation, and for high costs that are a significant burden for the public health insurance system. Above all, the diagnostic and prognostic value of coronary arteriography should be carefully evaluated and first priority should be given to the medical history and to noninvasive procedures for documenting coronary ischemia, as well as to investigations capable of assessing left ventricular dysfunction and the risk of rhythm disorders. Lastly, whether or not expected clinical benefits and cost considerations warrant use of myocardial revascularization techniques involving surgery or transluminal angioplasty should be discussed in the light of the full range of clinical and paraclinical data available.