The SHAPE guidelines

Back in July 2006, some of the biggest names in cardiology signed their name to the controversial "SHAPE task-force report," which recommends screening of all "at-risk" men between the ages of 45 and 75 and all at-risk women age 55 to 75. Experts and representatives of the major cardiology societies have now spent years debating the so-called "guidelines," even as legislators in Texas moved ahead with a bill based on the report.

No support for noninvasive CV-imaging screening role in analysis
A meta-analysis of randomized, controlled trials found no evidence that such screening for subclinical disease has a significant effect on primary-prevention strategies.

Texas Heart Attack Prevention legislation "premature," expert says
The quiet passage of a bill in 2009 that mandates insurance coverage for atherosclerosis screening will have "loud" ramifications for public health, Dr Amit Khera predicts, even as Florida legislators are poised to consider a similar bill.

Dueling advice: New ACC/AHA risk assessment guidelines, SHAPE II released on same day
The American College of Cardiology and American Heart Association release new guidelines on the assessment of cardiovascular risk in asymptomatic adults, while SHAPE draws attention to the planned revision of its screening guidelines.

SHAPE group proposes update to CAC, CIMT screening "guidelines" in time for AHA
The Screening for Heart Attack Prevention and Education task force II is developing a sequel to the controversial 2006 SHAPE guidelines on atherosclerosis screening that will incorporate evidence of important trials that have been completed since then.

Heart-attack prevention bill, mandating coverage for CAD screening, passes quietly in Texas
UPDATED // After a rocky ride in and out of the Texas legislature (twice) and most recently a perplexing pairing with bariatric surgery, the bill is now poised to become law September 1.

Should the ACC/AHA have taken a tougher stance on SHAPE?
A bill poised to go once again before Texas lawmakers that would mandate insurance coverage of certain heart scans has prompted a commentary in JAMA that asks whether professional societies should more vocally denounce "guidelines" like the SHAPE task-force report.

Texas bill, based on SHAPE paradigm, would require insurance coverage for calcium screening and carotid ultrasound
Seven months after the SHAPE task force first issued controversial "guidelines" recommending blanket screening for subclinical atherosclerosis, a member of the Texas House of Representatives has introduced a bill that would mandate insurance coverage of the tests. Advocates and skeptics alike question the likelihood of the bill's passage but say it will produce "needed" debate.

Bold new report calls for blanket screening of all "at-risk" men and women using CT and carotid ultrasound
The SHAPE task-force report recommends screening of all "at-risk" men between the ages of 45 and 75 and all at-risk women age 55 to 75 years. Experts and representatives of the major cardiology societies debate the so-called "guidelines," but many acknowledge imaging deserves a bigger role in preventive cardiology. The report appears in a supplement that is underwritten by Pfizer. (Naghavi M et al. Am J Cardiol; published online before print June 9, 2006.)

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