NYPD Cops at Greater Risk of Heart Disease;
DEA Program Finding More Damage than In General Public

By REUVEN BLAU

Initial results from a unique heart-scan testing system have shown that Detectives and other NYPD officers have exhibited increased signs of coronary artery disease at a younger age than the general population.

MICHAEL J. PALLADINO: Stay ahead of curve.

Based on prior data, 2 percent of men under 40 showed some level of plaque or calcium buildup in their hearts, according to Inner Imaging, which is affiliated with Beth Israel Medical Center. In contrast, 17.7 percent of the 2,000 Detectives screened with the Electron-Beam CAT Scan since last summer have displayed artery ailments, Inner Imaging officials said.

Earlier and Worse

"It is starting earlier and much more aggressive," said Albert E. Barrette, the managing director of Inner Imaging.

The test, called the Imatron Ultrafast Electron Beam Scanner, has the ability to "predict heart attacks," he added. Several of the city's uniformed unions are following the Detectives' Endowment Association's lead and offering the screening to their members at a reduced price.

The Chief-Leader/Michel Friang SCANNING THE TEST RESULTS: Initial findings from a unique heart scan test have shown that Detectives and other cops have an increased rate of heart problems than the general population. T.J. Matazzaro, left, and Albert E. Barrette, head the program for Inner Imaging, which is affiliated with Beth Israel Medical Center.

The medical field, however, has been slow to embrace the new technology. "Most of the negatives are pure ignorance," argued Mr. Barrette, who has tested himself four times. "It's just such a difficult struggle trying to separate ourselves."

The Fire Department and practically all the city's cardiologists have generally relied on more-conventional stress tests and screening programs for officers exhibiting heart ailments or with a family history of such problems.

Detects Signs Sooner

But Mr. Barrette argued that the Inner Imaging heart scan has the ability to discover calcium buildup and other problems before they arise. "We are able to see the earliest stages of coronary artery disease as much as 15 years before symptoms occur," the company's literature states.

DR. DAVID PREZANT: Questions value of test.

It is unclear whether the increased rate of heart ailments among officers who have taken the test is due to job stress and lifestyle choices or if it is tied to their work at Ground Zero.

Numerous reports have shown that first-responders who assisted in the rescue and recovery efforts at Ground Zero after the 9/11 terrorist attacks have incurred increased respiratory ailments and other potentially fatal sicknesses. Many of the city's Detectives sifted through rubble at Ground Zero, the City Morgue at Bellevue Hospital and the Fresh Kills landfill on Staten Island looking for evidence and other remnants.

Last summer, the DEA began offering its members discount prices for the test. The heart screening, which normally costs $500, is available to active Detectives for $175 and all retirees for $375.

DEA President Michael J. Palladino hailed the initial results. "The program has been so well-received by the membership that Inner Imaging had to open a second location," he said. "The more information that we find out with respect to 9/11 illnesses, the more popular the program becomes among the rank of Detective."

How Process Works

The scanner takes a series of high-resolution images of the heart with an electron gun. A staff physician then examines for flecks of calcium or plaque in areas where the three major coronary arteries are located. The results are then forwarded to each individual's primary care physician.

According to Mr. Barrette, over 2,000 independent clinical studies have shown that the screening is 98-percent accurate in detecting coronary heart disease.

The exam also closely looks at patients' lungs and abdomen, Mr. Barrette claimed. There are only two such scanners in the city, which cost $2 million and are both owned by Inner Imaging. The company plans to purchase two more machines in the next two years, he said.

Most insurance groups, however, do not cover the preventative screening, which has left the technology primarily available to wealthy individuals, Mr. Barrette said. "We have brought it to the middle-class at a price that's affordable," he asserted, after noting that President Bush and his entire family have been screened. "If we can eliminate 60 to 70 percent of cardiac events in all unions, then we are also lowering disability and morbidity costs."

FDNY Questions Risk

Last summer, Dr. David Prezant, the FDNY's Chief Medical Officer, noted that radiologists feel the abdominal and pelvic portion of the scan is not worth the added radiation "because it does not pick up early disease and does not replace proven screening methods such as colonoscopy. We don't want to give false impressions to patients."

Dr. Prezant at the time said he recommended that only high-risk patients undergo chest scans. "It is not meant to be a screening test," he remarked. "These chest CT tests are best served in a treatment program for those people who really need it."

He declined to comment last week. But it was clear that in response to the FDNY official's initial comments, Inner Imaging has modified its sales pitch to highlight the heart-screening aspect of the test.

Mr. Palladino scoffed at the cardiologists who question the test. "To those skeptics, I just say technology is a beautiful thing," he said. "My goal is to be ahead of the curve with respect to protection and detection for our people with respect to 9/11 illnesses. My position is, better have a jump on it, because we don't know what we are dealing with."

Detective Got a Break

Mr. Barrette cautioned that negative comments about the exam deter individuals from taking the test, which will ultimately cost lives. He talked about the many cases in which asymptomatic individuals discovered that they had severe blockages after being screened.

Recently retired Detective Keith Caramanica said he was "shamed" into taking the test by his partner last year. "I had no plans on going," he recalled. "She booked the appointment for both of us. At the time I really wasn't paying attention to how I was feeling. Heart trouble was the furthest thing from my mind."

But he was called into a meeting with Mr. Barrette after his exam. "At that time I knew something was wrong," Mr. Caramanica said. "Bert told me that there were some areas of concern on my test, so he suggested I see my cardiologist."

His doctor didn't immediately pursue the results because Mr. Caramanica told him that he was feeling well. But he then began to realize that he was experiencing tightness in his chest and numbness in his hand. "I started paying attention to my body," he said.

Eight weeks after his heart scan, his doctor scheduled an Angioplasty test. "I had a 99 percent blockage of my main coronary artery, the one they call the widow-maker," he said. "The doctor put two stents in to clear the blockage. He said I was a heart attack waiting to happen."

Four days after that procedure, his family was gathered in town for Christmas. He told his father about the symptoms he had felt. "I could see his face change," he remembered. "The following morning he checked himself into the hospital and later underwent a quadruple bypass."

'A 2-for-1 Save'

Everything started with the Inner Imaging test, Mr. Caramanica said. "I credit Inner Imaging with a two-for-one save," he added. "And my father's sister, my aunt, just went and had a double-bypass done. We've been getting a lot of mileage from this thing."

Mr. Palladino said he has received many letters from people like Detective Caramanica describing their experiences.

T.J. Matazzaro, Inner Imaging's Chief Technical Director, noted that the American Heart Association in January "recognized the value of the test." Asked why more doctors haven't embraced the screening, he responded, "I don't think they really know the value of prevention."

He pointed out that 30 percent of people who suffer heart attacks "don't get a second chance." As for the screening, he added, "A lot of people have heard of it, and a lot of people know about it, but not many physicians know how to use it."