Angiogram breakthrough could see invasive coronary tests plummet

30 Aug 2016

Medical researchers have found a way to dramatically lower the need for ‘invasive coronary angiography’ (ICA), with CT imaging instead pointing the way forward.

When investigating patients with suspected heart disease, researchers have found that the use of non-invasive CT imaging could be the most effective (both in terms of cost and impact on patients) model available.

A trial showed a drop of 86pc in the number of people found to need ICA following a CT, with the CT imaging diagnosing those who were really in need.

Angiogram heart disease

“Our study observed lower rates of invasive procedure, which were also associated with cost savings,” said Hyuk-Jae Chang, a doctor who worked on the trial for CONSERVE (Coronary Computed Tomographic Angiography for Selective Cardiac Catheterisation).

“The message from this trial is that, if we use coronary CT angiography as a gatekeeper to the catheterisation lab in stable symptomatic patients with suspected coronary artery disease, we’ll reduce costs with sufficient safety.”

More than 1,500 patients were involved in the trial, with an average of more than $3,000 saved, per patient, due to the reduced need for invasive procedures.

The study was revealed at the European Society of Cardiology Congress, held in Italy. At the same event, a separate study from the UK found that cardiovascular magnetic resonance (CMR) was the preferred diagnostics tool, again replacing the need for invasive tests in all cases.

“Rates of invasive angiography are considered too high among patients with suspected coronary heart disease,” said Prof John Greenwood, lead author on the study published in JAMA.

“Our findings show that both cardiovascular magnetic resonance (CMR) and myocardial perfusion scintigraphy MPS significantly reduced rates of unnecessary angiography compared to guideline-directed care.”

Greenwood said there was no subsequent “penalty” on patients, “in terms of major adverse cardiovascular events”.

“This suggests that functional imaging should be adopted on a wider basis, even in high-risk patient subgroups.”

Heart failure is expected to triple by 2060 among the elderly, according to another study revealed at the congress. “Heart failure is a common condition worldwide and increases with age,” said lead author Prof Ragnar Danielsen.

“Various disorders can cause heart failure, such as coronary heart disease, hypertension, obesity and diabetes. As these are more prevalent with age the consequence is an increased population of elderly who may develop heart failure.”

Finding easier, faster, cheaper and less-invasive processes to diagnose potential heart disease, so, is a welcome development.

Main heart disease image via Shutterstock

Gordon Hunt was a journalist with Silicon Republic