CT angiography proves useful in heart attack risk prediction
According to a study published in the journal Radiology, coronary computed tomography angiography (CCTA) is an effective method in determining the risk of myocardial infarction in patients with suspected coronary artery disease. Jonathon Leipsic, MD, FRCPC, from the University of British Columbia in Vancouver, the study’s first author, says that CCTA may be considered first-line investigation in patients with atypical angina and suspected but not confirmed coronary artery disease.
According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death in the United States and worldwide. Treatment in heart disease mainly addresses the risk factors that can be modified such as blood pressure, high cholesterol, smoking, diabetes, obesity. It should be noted that in addition to these modifiable cardiovascular risk factors, there are also other non-modifiable risk factors such as age (old age), sex (males) or familial history. In other words, cardiovascular disease can be prevented in part by adopting a healthy lifestyle (healthy diet, sport) and by quitting smoking. On the other hand, there are situations when these risk factors such as blood pressure or high cholesterol cannot be reduced only through lifestyle changes, and then one has to resort to medication, such as antihypertensives or statins (drugs that lowers cholesterol).
The main symptom in coronary artery disease is angina, which is chest pain. But there are cases when the patient is symptomatic, that is he has chest pain but the risk factors cannot be identified. Dr. Leipsic said that this situation is common in clinical practice this is why a tool to stratify these patients is strongly needed. CCTA is a non-invasive method with high accuracy that can help diagnose or exclude coronary artery disease. However, currently, the suspicion of coronary artery disease is based on clinical risk factor scoring.
Therefore, Dr. Leipsic and colleagues made research on 5262 patients with suspected coronary artery disease without medical modifiable risk factors. Then the CCTA results were correlated with the risk of major adverse cardiac events. It was found an increased prevalence of coronary artery disease because more than a quarter of patients had non-obstructive disease or disease related to the buildup of plaque in the arteries. “We found that patients with narrowing of the coronary arteries on CT had a much higher risk of an adverse cardiac event,” Dr. Leipsic said. He added that they are collecting data in order to determine the prognostic value of CCTA after five years or more of follow-up.