SHAPE Task Force Applauds President Bush's Medical Team for Recognizing Value of Screening to Prevent Heart Attacks

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It's tragic that all Americans can't benefit from such life-saving screening tests because most insurance companies do not pay for it.

The Society for Heart Attack Prevention and Eradication (SHAPE) congratulates President Bush on his return to good health after undergoing surgery to treat a blocked coronary artery using a stent. This procedure is called a percutaneous coronary intervention (PCI).

Also to be recognized is the President's medical team that performed the original CT screening for coronary calcium in 2004 as part of his annual physical exam. When the results of this noninvasive imaging procedure found a small amount of calcification (indicating plaque build-up) in the President's coronary arteries he was prescribed a daily aspirin and cholesterol-lowering medication.

With this knowledge of cardiovascular risk, the President was given a stress test and electrocardiogram on Tuesday during his annual physical exam even though he had no indication of heart problems. The results prompted his doctors to do a computed tomography angiogram (CTA) , which led to the discovery of sufficient blockage to warrant the stenting procedure. As a result, President Bush's prognosis is excellent and he will be able to return to his busy schedule later in the week.

Without undergoing the coronary calcium scan and having the opportunity to treat the spread of the plaque, his disease would very likely have been far worse and his prognosis less benign. The President is the beneficiary of the responsible precautionary practices of his doctors that embraced the same guidelines developed and promulgated by SHAPE.

In 2004, when the President's medical team thought to prescribe a coronary calcium screening test, SHAPE was the first to recognize these forward thinking doctors for setting in motion a regimen of treatment and monitoring that continues to safeguard President Bush's heart health to this day. See:

The same interest in prevention could not, however, be attributed to President Clinton's medical team. Its reliance solely on traditional risk factors to identify the former President's growing cardiovascular disease might have cost him his life, as SHAPE pointed out in a press release at the time: See:,%20A%20Vulnerable%20Patient.htm .

Clinton was extremely fortunate to feel some of the warning signs - chest pain and shortness of breath - that prompted his emergency bypass surgery. The chief of cardiology at the hospital where the procedure was performed said that " there was high likelihood that he would have suffered a substantial heart attack in the near future."

Unfortunately, over 600,000 Americans die each year from heart attacks. Sadder yet is the knowledge that these deaths can be greatly reduced by undergoing the very same screening test given to President Bush in 2006.

However, without government recognition of the life-saving value of this noninvasive and inexpensive calcium screening test, it is not being prescribed by primary care physicians, a clear case of being "penny wise a pound foolish." It's time to make sensible changes that will benefit the health of every American adult.

"In the long run, noninvasive cardiovascular screening will prove to be more cost-effective in preventing heart attacks than basing treatment, or lack thereof, on traditional risk factors, such as high cholesterol and blood pressure, alone," said Dr. Morteza Naghavi, SHAPE Task Force chair and founder of the Society for Heart Attack Prevention and Eradication.

The SHAPE Task Force's leadership in educating physicians to adopt preventive strategies to better serve their patients has been catching on as a result of its ongoing medical symposia and accredited training programs for hospitals and doctors.

The Task Force is comprised of leading cardiologists and researchers from around the world. They believe that the medical community's reliance solely upon traditional risk factors to identify patients in need of intervention has serious limitations.

The group is advocating for the adoption of the National SHAPE Program, a highly effective new treatment approach based on screening for subclinical disease. Taking into consideration traditional risk factors, its aim is to help physicians identify the "vulnerable patient," that is, individuals at very high risk of an imminent heart attack.

Modeled after successful screening efforts in the cancer-care arena, the SHAPE Guidelines encourage men 45 and older and women 55 and older to undergo noninvasive screening to determine their risk of heart attack. Today, two methods are widely available that effectively determine the presence and severity of structural abnormalities, namely plaque buildup or thickening of the arteries (atherosclerosis):

1.    Coronary calcium score using a CAT scan, which is used to determine the burden of plaque build-up in the coronary arteries; and

2.     Thickness of the carotid artery wall and presence of plaque measured by ultrasound, which correlates with an individual's total burden of arterial plaque build-up or atherosclerosis.

"The tragedy is that most insurance programs and Medicare fail to cover these procedures, so they remain out of financial reach of the average American," said Dr. Harvey Hecht, a member of the SHAPE Task Force and Associate Director of Cardiovascular Imaging at Mount Sinai Medical Center in New York.

"It defies reason that cancer screening procedures, such as colonoscopy and mammography are well accepted and reimbursed by the government and insurance companies while life-saving screening tests to prevent heart attacks, the number one killer in this country, are not covered."

The Society for Heart Attack Prevention & Eradication (SHAPE) is a nonprofit organization created to promote public awareness, professional education and research related to early detection, prevention and treatment of atherosclerosis (arterial plaque), the most prevalent underlying cause of heart attacks and stroke. SHAPE is committed to educating doctors and their patients about the devastating consequences of not screening for the accumulation of arterial plaque. Identifying and treating coronary risk factors such as smoking, diabetes, obesity, high blood pressure and high cholesterol are simply not enough. Additional information is available at: To get involved with SHAPE and become a volunteer, please email us at: info(at)shapesociety(dot)org or call 713-529-4484.

The SHAPE Task Force, an international group of leading cardiovascular physicians and researchers, has created the SHAPE Guidelines designed to educate physicians how to identify asymptomatic atherosclerosis (hidden plaques) and implement proper therapies to prevent future heart attacks. According to the SHAPE Guidelines, individuals with high risk of atherosclerosis (high plaque score) should be treated even if their cholesterol level is within the so called “normal range.” Knowing one's plaque score is critical. In fact, it can be a matter of life and death! Additional information is available by calling 1-877-SHAPE11. Additional information is available at

The SHAPE Task Force includes the following:

Morteza Naghavi, M.D. – Executive Chairman
PK Shah, M.D. – Chair of Scientific Board
Erling Falk, M.D., Ph.D. – Chief of Editorial Committee

SHAPE Task Force Members (alphabetic order):
Arthur Agatston, M.D., Daniel S. Berman, M.D., Matthew J. Budoff, M.D., Raimund Erbel, M.D., Erling Falk, M.D., Ph.D., Sergio Fazio, MD, PhD, Steven B. Feinstein, M.D., Craig Hartley, Ph.D., Harvey S. Hecht, M.D., Howard Hodis, M.D., Ioannis Kakadiaris, Ph.D., Sanjay Kaul, M.D., M.P.H., Asher Kimchi. M.D., Wolfgang Koenig, M.D., Ph.D., Iftikhar J. Kullo, M.D., Daniel Lane, M.D., Ph.D., Roxana Mehran, M.D., Ralph Metcalfe, Ph.D., Morteza Naghavi, M.D., Tasneem Z. Naqvi, M.D., Jagat Narula, M.D., Paolo Raggi, M.D., George P. Rodgers, M.D., James HF Rudd, Ph.D., Robert S. Schwartz, M.D., PK Shah, M.D., Leslee Shaw, M.D., David Spence, M.D., H. Robert Superko, M.D., Henrik Sillesen, M.D., Ph.D., Pierre-Jean Touboul, M.D.

Chair of SHAPE Board of Directors: JoAnne Zawitoski
SHAPE Task Force Executive Coordinator and SHAPE CEO: Richard Hellner
Executive Director of SHAPE Centers of Excellence: Jeff Fine, Ph.D.

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