Shortage of stress test dye linked to more invasive procedures

A global shortage of a radioactive substance used in exercise stress tests is linked to a 10 percent increase in heart catheterizations, according to a study published in the journal JAMA Cardiology.

Physicians inject the harmless radioactive substance — called technetium Tc 99m — to help diagnose or rule out coronary artery disease in patients. However, recent nuclear reactor shutdowns have caused shortages of the substance, forcing physicians to perform cardiac catheterizations to get the same information. Some physicians have also turned to using other radioactive substances associated with higher radiation exposure and less accurate results.

Venkatesh L. Murthy, MD, PhD, of the University of Michigan in Ann Arbor, lead the study, which analyzed data from Medicare to discover how the shortages affect cardiac stress testing and cardiac catheterization in adults 65 years and older.

They found recent global shortage of the radioactive isotope technetium Tc 99m caused about a 10 percent increase in heart catheterizations.

"Due to the complexities of the healthcare system, it isn’t that often that we can tie supply chain issues such as this to direct healthcare outcomes," Dr. Murthy said in a Reuters report. "Several companies have developed technologies to produce the technetium without using weapons-grade uranium. What is not completely clear yet is whether they will be able to operationalize these technologies and ramp up supply quickly enough."

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