A study has claimed that offering people suspected of having a certain type of heart attack MRI scans could help thousands of patients avoid an invasive procedure.
Academics from the University of Oxford explored the approach in patients who had suffered a non-ST segment elevation myocardial infarction (NSTEMI) heart attacks.
They happen when the arteries that supply blood to the heart are significantly narrowed but not completely blocked.
There are about 50,000 hospital admissions a year for this type of heart attack, according to researchers.
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It is recommended these patients have a coronary angiogram – a small tube inserted into the artery, allowing doctors to check for narrowing or blockages – within 72 hours of hospital admission.
However, the study found about a fifth of patients could avoid the procedure if an MRI is carried out beforehand.
Some 100 patients admitted to hospital with a suspected NSTEMI heart attack were recruited for the Oxford Acute Myocardial Infarction (OxAMI) study.
They were given a heart MRI scan before the angiogram, with clinicians making their diagnosis separately and without knowing the results of the other procedure.
Of the group, 27 patients did not have any major narrowing of the arteries.
The MRI scan showed 18 of these patients had a normal heart, or had other conditions such as inflammation of the heart.
Dr Mayooran Shanmuganathan, consultant cardiologist and research fellow at the University of Oxford, said: “While this was a small study in one hospital, if we find similar results in a larger multi-centre trial it could help thousands of patients every year to avoid an invasive procedure that will not benefit them.
“We now need to test this non-invasive approach on a bigger scale, by using heart MRI scans to guide treatment decisions in patients suspected to have NSTEMI heart attack to determine its cost-effectiveness and the impact it has on longer-term clinical outcomes.”
The research was funded by the British Heart Foundation (BHF) and the National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre.
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The findings have been presented at the British Cardiovascular Society conference in Manchester and published in the Journal of American College of Cardiologists (JACC) Cardiovascular Imaging.
Dr Sonya Babu-Narayan, associate medical director at the BHF, said: “With an ageing and increasingly unhealthy population, along with ongoing disruption to the health system and the effects of Covid on the cardiovascular system, the number of people with heart disease in the UK is set to increase.
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“It’s vital that we can get everyone on a path to receive the tests and treatment they need as quickly as possible to save and improve more lives.
“Invasive procedures like coronary angiograms will continue to have a crucial role in heart care, delivering important treatments such as stents that can help to save lives and stop future heart attacks.
“But if the results of larger trials are positive, this scan-first approach could help doctors to identify patients who don’t stand to benefit, allowing them to avoid the small but important risk of complications.”
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