Non invasive imaging can predict future heart attacks

March 2017:

Now you can protect your family and friends from heart attacks as a study reveals that noninvasive CT angiography and stress tests can help predicting it. The study appeared online in the journal Radiology.

According to researchers, a combination of invasive coronary angiography (ICA) and stress tests with single photon emission tomography (SPECT) myocardial imaging has been the gold standard for making these determinations, with ICA showing the blockages and SPECT the perfusion, or penetration of the blood into the tissue.

"Previous studies show that a lesion is hemodynamically significant if there is a noteworthy blood pressure drop corresponding to a big reduction in blood flow across the stenosis," said study author Joao A.C. Lima.

"If plaque has those characteristics, the patient should be targeted for intervention, be it with a stent or downstream bypass surgery."

The researchers set out to determine if combined CT angiography (CTA) and CT myocardial stress perfusion imaging (CTP) could demonstrate similar or superior ability to ICA/SPECT in predicting future adverse events.

"Invasive angiography is generally safe, but it can cause vascular problems in a significant number of patients, most commonly at site of the puncture," Lima said.

"Now with just one noninvasive test we can get two important but different pieces of information about the coronary arteries," said co-author Marcus Chen.

They compared the invasive and noninvasive approaches on 379 patients, who were referred for ICA, from November 2009 to July 2011.

The researchers looked at the ability of both techniques to predict whether or not a future major adverse cardiac event (MACE)- such as a heart attack, revascularisation, arrhythmia or hospitalisation for chest pain or congestive heart failure- would occur.

The results indicated that 51 patients experienced one or more major adverse cardiac events, including 49 revascularisations, five myocardial infarctions - a heart attack, one cardiac death, nine hospitalisations for chest pain or congestive heart failure and one arrhythmia - a condition in which the heart beats with an irregular or abnormal rhythm.

"The noninvasive option should be a preferred or at least strongly considered option by cardiologists and radiologists managing these patients because it is safer and less expensive, and patients like it better," Chen stated. Times of India