Given the daunting Centers for Disease Control and Prevention statistic of nearly 700,000 deaths caused by heart attacks in 2020, the standard package of screening tests, which includes the stress test, the CT arteriogram, and ranking cholesterol levels, falls short of predicting risk. More sophisticated and reliable screenings lie in two quick, easy, and noninvasive tests that provide clear, photographic measures of the plaque that leads to blockage and potential rupturing of the artery wall, causing cardiac arrest.
According to Dr. Nishath Hakim, an internal medicine specialist in Bloomfield Hills, the cardiac CT calcium scoring test, which assesses and renders a numerical score for the level of plaque in the arteries, remains a seldom-prescribed test, even though it’s now performed as an outpatient procedure at almost every hospital. It is not covered by insurance and costs about $100.
The more dependable test is the CIMT, or carotid intima-media thickness test, says Dr. Brian Kolender, an internal medicine specialist based in Bingham Farms who focuses on heart attack and stroke prevention. This noninvasive, focused ultrasound of the neck arteries, which takes about 10 minutes, can predict with 85 to 95 percent accuracy a patient’s risk of suffering a stroke or heart attack within the next 10 years. The CIMT identifies objective visual markers that indicate risk better than any of the standard tests and is considered by physicians who specialize in prevention to be the gold standard.
Hakim and Kolender both stress the importance of the CIMT test for all patients at increased risk for heart attack or stroke. With interpretation and medical management, says Kolender, patients can reverse the plaque buildup and reduce the risk of cardiovascular events to essentially zero. The test costs around $250 and is also not covered by insurance.
The Big C, unfortunately, is often identified too late to be eradicated, at a period more specifically referred to as stage 4. According to the American Cancer Society, an estimated 600,000 people died from cancer last year in the U.S. The deadliest cancers — pancreatic, ovarian, liver, and lung — are often symptomless prior to end-stage disease.
At the end of 2021, Grail, a California health care company, announced the blockbuster news of its newly developed Galleri multicancer early detection test. With a simple blood draw, it has the capability to detect more than 50 types of cancer, including esophageal, pancreatic, gall bladder, and ovarian. Also effective in determining the cancer’s exact location within the body, this high-sensitivity test allows for the diagnosis of the deadliest cancers at stage 1, when treatment is still possible. Known as a liquid biopsy, the test utilizes methylation tags that discern genetic differences between normal cells and cancerous ones. It has a high negative predictive value, returning negative results with 95 percent accuracy. Patients should inquire whether their doctor provides this groundbreaking screening, which requires prescription by a licensed health care professional. Physicians can acquire the Galleri test kit directly from the company. It is not covered by insurance and costs about $950, depending on the provider.
The call to action is for us all to be aware of the available early screening options, ally with doctors who specialize in prevention, and become consumers of health care, rather than passive patients.
This story is from the 2022 edition of Health Guide. Read more stories here.