Nuclear threat to heart patients? Experts show impact from shortage of radioactive stress test tracer

But in October, many such patients may not be able to get the best possible test, due to a looming shortage of a crucial short-lived radioactive element.

Called technetium-99m or Tc-99m, it’s the one of the best ways to test for those blockages from outside the body. But one of the key sources for U.S. patients will stop producing it in October. And the situation may worsen, depending on what happens in the global nuclear realm.

This means many heart patients could end up getting less-precise stress tests, or more invasive, riskier and more costly heart imaging instead, according to University of Michigan Medical School research recently published in JAMA Cardiology.

Researchers led by heart imaging specialist Venkatesh Murthy, M.D., Ph.D. looked at data from two million Medicare participants who needed heart scans in the four years surrounding a six-month technetium shortage in 2010. The shortage happened when two Canadian plants responsible for much of the U.S. supply went offline.

As hospitals tried to compensate for the lack, more patients had less-precise thallium-based scans that may have prompted doctors to send them for follow-up using a costly invasive heart-imaging procedure. In fact, the study finds, over 5,700 additional patients ended up having such procedures — called coronary angiography — during the shortage, exposed them to more risk and radiation.

This week, Murthy presented the findings and more to a summit of nuclear experts who are grappling with the issues related to Tc-99m production. He also shared results from a small Canadian study of the 2010 shortage, showing similar patterns.

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