Department of Research & Evaluation News

A new Kaiser Permanente study explores factors that might influence whether people with new-onset heart failure get tested for coronary artery disease. Published November 1, 2024, in JACC: Advances, it suggests that physician perceptions of the risks and benefits of testing, patient preferences, and socioeconomic challenges may all come into play.

The study follows research published earlier this year showing that, among some patients with new-onset heart failure, testing for coronary artery disease within 90 days could reduce the risk of hospital readmission — even if patients are not tested until after they go home.

“Our findings underscore the benefits of testing, while also providing reassurance that we can personalize the timing according to what’s best for each patient,” said Cheng-Wei “Charlie” Huang, MD, clinician investigator with the Kaiser Permanente Southern California Department of Research & Evaluation, and a hospitalist at the Kaiser Permanente Los Angeles Medical Center, who helped to lead both studies. The lead author on the study was Siamak Kohan, MD, an internal medicine resident who is now a cardiology fellow at Los Angeles Medical Center.

In coronary artery disease, arteries that deliver blood to the heart become narrowed or blocked. Testing for it can include various approaches, such as exercise stress testing, imaging, and more invasive procedures that access the heart.

For the earlier study, the researchers analyzed the electronic health records of more than 2,700 Kaiser Permanente Southern California members who were hospitalized for new-onset heart failure. Specifically, they only looked at patients with reduced ejection fraction, meaning their heart muscles did not pump blood out to the body efficiently.

They found that patients who were tested for coronary artery disease within 90 days of hospital discharge had a 29% lower chance of being readmitted to the hospital for heart disease or dying from any cause. This benefit persisted no matter when patients were tested within the 90-day period. The findings appeared on January 18, 2024, in the Journal of General Internal Medicine.

“A decision to delay testing could be easier to make in an integrated health system like Kaiser Permanente, which allows for shared decision-making and smooth care transitions so patients may be less likely to fall through the cracks,” Dr. Huang said. “Ultimately, our research could lead to strategies for ensuring that more people benefit from testing.”