February is American Heart Month and consumers will be bombarded with advice to keep their ticker healthy—whether it’s from the American Heart Association’s go Red For Women or the National Heart, Lung, and Blood Institute’s The Heart Truth.

Doctors may suggest a screening test to make sure cardiovascular health is in top shape. But if a person lacks symptoms—like chest pain or shortness of breath—they might want to hit pause for a second and look closer at the costs and benefits.

The fact is, there is no good evidence that any of the common tests are that helpful if a person is symptom-free.

“If you do a test like a stress test in someone who doesn’t have any symptoms, then you are more likely to get a false-positive test than a true positive,” said Dr. Malissa Wood, a spokesperson for the American Heart Association.

Such false alarms trigger more unnecessary tests, which often carry significant risks.

“We really want to go based on symptoms,” Wood said.

The government-backed U.S. Preventive Services Task Force also advises against routine screening for heart disease for people at low risk.

Even for those at higher risk—like smokers, diabetics and the obese—there is insufficient evidence to support routine screening, according to the USPSTF, which bases all of its advice on rigorous science.

Still, groups with ties to drug and heart device makers often recommend the tests routinely, and several companies promote them, to the chagrin of experts in the field.

“There are no ‘heart tests’ that any asymptomatic man or woman should get,” said Dr. Patrick O’Malley, an internist at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. “There are many that are done which they shouldn’t get.”

Here’s a brief guide to the common heart tests:

Test 1: ECG (EKG)

What is it? an electrocardiogram, or ECG, is simply a readout of your heart’s electrical activity recorded by electrodes placed on the chest. it can pick up abnormalities that might, or might not, signal heart disease in the making.

Does it work? ECGs are used to study irregular heart rhythms, heart attacks and other problems. They’re also used before some types of surgery, but no trials have looked at whether ECGs help stave off disease in people without symptoms.

What’s the harm? an ECG typically costs about $50. Because it’s not invasive, the test itself is safe. What someone should worry about is what happens if the results look abnormal. a patient might end up with another test that carries more risks, like a CT scan or a coronary angiogram, during which a catheter is threaded into the heart.

Test 2: Carotid Ultrasound

What is it? a carotid ultrasound allows doctors to see if the arteries in the neck that supply blood to the brain, called the carotids, are clogged by cholesterol buildups, or plaque. that is considered a risk factor for stroke.

Does it work? This test is used to check the blood flow to the brain. there is no evidence that carotid plaque screening, which is becoming increasingly popular, saves lives. The USPSTF says the harm of routine scans outweighs the benefits.

What’s the harm? an ultrasound of the carotids costs between $200 and $300. Routine scans produce more false alarms than “true positives,” and may lead to invasive imaging or carotid surgery or stenting. between one and three percent of patients who get carotid surgery die due to the procedure, and even more suffer strokes from it.

Test 3: Echocardiogram

What is it? an echocardiogram is a moving ultrasound picture of the heart. it allows the doctor to test how well the heart pumps out blood and whether it has structural problems.

Does it work? While the test might help doctors diagnose conditions like heart failure and atrial fibrillation, it hasn’t been proven to help people without symptoms. one recent study found screening for heart disease with echocardiography and other tests didn’t change what drugs doctors prescribed, nor people’s diet and exercise habits or whether they smoked.

What’s the harm? an echocardiogram costs between $200 and $300. Ultrasound scans are generally safe, but can trigger false alarms and may lead to more-invasive tests and treatments later.

Test 4: Stress Test

What is it? To spot signs of pumping problems, a doctor will stress the heart by putting a person on a treadmill or stationary bike while doing an echocardiogram or an ECG. in a nuclear stress test, radioactive dye is injected into the bloodstream to create a better picture.

Does it work? Stress tests can help diagnose heart problems but haven’t been shown to be helpful screening tools. some studies have shown they may miss signs of heart disease.

What’s the harm? a stress test may cost anywhere from a few hundred dollars to $1,000. it carries the usual risks of exercise, but largely for people with heart problems — including very rare cases of heart attack. some tests will result in false alarms, meaning further procedures with possible complications will be done unnecessarily.

Test 5: Cardiac CT Scan

What is it? CT (computed tomography) scans use high-dose x-rays to get a detailed picture of the heart. in a coronary calcium scan, the doctor looks for calcium deposits in the heart’s arteries, which have been tied to an increased risk of heart disease. Patients may also have a dye injected to make it easier to spot blockages.

Does it work? CT scans may help separate women at moderate risk of heart disease into those who would benefit from aggressive treatment and those who wouldn’t. But for people without symptoms, CT scans still haven’t proved more valuable than medical advice based on well-known risk factors like diabetes and obesity.

What’s the harm? The radiation from CT scans, which may cost several hundred dollars, may increase one’s cancer risk slightly. When dye is used, about one in 10 people develop kidney damage and some may get thyroid problems, too. False alarms may lead to invasive tests, which carry more risks.

HEALTHY LIVING, NOT TESTS

Experts say the best way to prevent heart disease has little to do with technology and everything to do with lifestyle.

“Tests do not prevent heart disease,” said Dr. Rita Redberg, a cardiologist at the University of California, San Francisco. “To prevent heart disease, women (and men) should eat healthy diets with lots of fruits and vegetables, get regular physical activity and not smoke.”

The American Heart Association also recommends keeping your blood pressure and cholesterol levels under control, although the USPSTF says there is too little evidence to recommend cholesterol tests when women don’t have other heart risks.

As reported by Patrick Crutcher

In many ways, 2011 should be a transformative year for Aastrom Biosciences (Nasdaq:ASTM).   to start off the year, they will be presenting Phase 2 Surgical-DCM 6-month results sometime this month, followed up by several(3-5) other key catalysts that investors should be looking for in 2011. We think they have the potential to become the clear leader in stem cells for cardiovascular diseases.

Aastrom’s Tissue Repair Cell(TRC) technology is an autologous based platform, meaning they use a small sample of a patients bone-marrow. Their TRC platform then expands the number of stem and progenitor cells many times(49 times) what would otherwise be obtained from patients, and these cells are then delivered directly to the damaged tissue. they are currently focusing their efforts on critical limb ischemia and dilated cardiomyopathy(DCM).

Let’s take a minute to focus on DCM. DCM is a condition in which the heart becomes weakened and enlarged, and it cannot pump blood efficiently. The decreased heart function can affect the lungs, liver, and other body systems. As we said, we are anticipating Phase 2A Surgical-DCM 6-month results sometime this month, based on guidance given by management. At the American Heart Association in November 2009, Aastrom presented positive interim results from a small-subset of patients. they demonstrated that their TRCs showed clinically meaningful improvements in NYHA function class for patients on therapy. after 6 months, 4 of the 5 patients receiving cell therapy demonstrated improvement NYHA functional class; while 4 of the 5 in the control group either did not improve or deteriorated. NYHA function is used to assess the stage of heart failure; this system relates symptoms to everyday activities and the patient’s quality of life. See the data here (aastrom.com/releasedetail.cfm?ReleaseID=424306).

Back in mid-July, Aastrom released news about the extension study in the DCM indication; this could be potentially indicative of the TRCs positive effects. The extension study is designed to offer control-group patients from the IMPACT-DCM trial the opportunity to receive treatment with an expanded mixture of their own bone marrow-derived stem and progenitor cells after completing at least 6 months of follow-up. they are most likely offering the control patients the TRC treatment because of the significantly more positive results in the treatment arm and very poor survival in the control. (This came after a positive review of safety and efficacy data by the IMPACT-DCM data safety monitoring board (DSMB) for the first 20 patients who participated in the IMPACT-DCM trial. Independent approval of the amended protocol and initiation of the extension study has also been granted by all institutional review boards (IRBs) affiliated with theclinical study sites.)Investors should read/watch this local news story (ksl.com/?nid=148&sid=9861660) on how ASTM’s treatment has helped out several patients. Dr. Patel is the lead clinical investigator for that study. there was also another recent news story broadcast about Aastrom’s technology in DCM and how it has really helped out one of their treated patients. See the video here (bit.ly/hmpGDj). hopefully these positive stories about DCM patients treated with TRCs are a precursor to overall positive results in the study. The company intends on announcing Phase 2 Surgical-DCM 12 month results sometime in Q2/Q3. We are also expecting some data from their Phase 2 Catheter DCM trial sometime in Q2.In November they presented positive and consistent results in critical limb ischemia(CLI) from their Phase 2b RESTORE-CLI trial. Their TRCs demonstrated statistical significance in the primary endpoint, time-to-treatment failure(TTF), which includes death, amputation, de novo gangrene and doubling in wound size. they also saw extremely favorable trends in the secondary endpoint, amputation-free survival(AFS), but did not see statistical significance due to unusually low event rate in the control arm. for example, they saw no zero(0) events in the control group between interim analysis 1 and 2, which historically speaking is highly unlikely given the historical event rate of 50%. The 12-month data on the RESTORE-CLI data could potentially show changes that reflect the TRCs differentiation over the control arm over the long-term. (Note, the trial was not designed to show significance in the secondary endpoint.)Going forward in 2011 with CLI, we are awaiting several catalysts on this front that should have a positive impact on their value. In October, Aastrom announced plans to initiate a Phase 3 CLI clinical development program under special protocol assessments (SPA) with a Fast Track designation by the FDA. We expect to hear more about the SPA negotiations for Phase 3 in CLI with FDA sometime over the next month or so. Additionally, Aastrom will be presenting the Phase 2b CLI 12-month results in Q2. they are also in active discussion with potential partners for CLI in the EU; these are currently early conversations, but certainly indicative of interest in the program.they recently raised $22.5 million($20.5m after fees) in December, which should certainly carry them through most of 2011. This was on top of cash on hand of $10.5-11 million at the end of 2010. Both Roth Capital and Zack’s have them rated as a ‘BUY’ with $5 price targets. We like the potential Aastrom has in 2011 and believe positive results could really differentiate them from the competition in this space. Our interview with Aastrom’s CEO – biomedreports.com/2010120861096/aastrom-interviewed-about-recent-phase-2-study.html

IMPACT-DCM Interim results – bit.ly/ijCVGJ

IMPACT-DCM extension study for control patients – bit.ly/fiwgZp

IMPACT-DCM final patient treated – bit.ly/femMDB

Zack’s Research on ASTM(great overview of DCM) – bit.ly/cUzqlS

Zack’s update following CLI data in November, $5 PT – slideshare.net/pslice84/astm-restore-cli-update-nov-2010

Doctors using stem cells to repair failing hearts – ksl.com/?nid=148&sid=9861660

Local Stem Cell Company Meets Survivor – bit.ly/hmpGDj

Disclosure: Long ASTM