Noninvasive Imaging Helps Predict Heart Attacks
Noninvasive CT angiography and stress tests can help predict which patients are likely to suffer a heart attack or other major adverse cardiovascular events (MACE), according to a new Radiology study.
Marcus Y. Chen, MD, from the National Institutes of Health in Bethesda, MD, and colleagues compared invasive and noninvasive approaches in 379 patients who were referred for invasive coronary angiography (ICA) from November 2009 to July 2011. The patient population came from the Combined Noninvasive Coronary Angiography and Myocardial Perfusion Imaging Using 320-Detector Row Computed Tomography (CORE320) prospective multicenter diagnostic study.
Fifty-one patients, or 13.5 percent, experienced one or more MACE, including 49 revascularizations, five myocardial infarctions, one cardiac death, nine hospitalizations for chest pain or congestive heart failure and one arrhythmia.
Both techniques proved to have similarly high values for predicting MACE at two years after presentation and event-free survival. The two-year MACE-free rates for combined CT angiography and CT perfusion findings were 94 percent negative for coronary artery disease (CAD) versus 82 percent positive for CAD and were similar to combined ICA/single-photon emission CT (SPECT) findings (93 percent negative for CAD vs. 77 percent positive for CAD).
“The traditional approach with invasive catheterization requires that patients go to the hospital, get a catheter inserted into their leg and go in for the nuclear SPECT study on a different day. Now with just one noninvasive test we can get two important but different pieces of information about the coronary arteries,” Dr. Chen said.
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