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MRI ‘best non-invasive way’ to diagnose heart disease

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Magnetic resonance imaging (MRI) scans are the “safest and most effective” way to identify high risk patients with cardiac chest pain, according to UK researchers.

The Leeds University study showed that cardiac MRI was better overall at predicting serious events, such as death or heart attack, following chest pain suspected to be angina.

“The outcomes of this study could lead to changes in clinical guidelines”

John Greenwood

They carried out a five-year follow-up study to find out the best way of separating patients based on whether they were at high- or low-risk of serious heart events.

They noted that patients with suspected angina were currently most likely to be tested with either an x-ray angiogram or SPECT, a non-invasive procedure that involves ionising radiation and which is damaging to living cells.

The research, published in the journal Annals of Internal Medicine, compared the accuracy of MRI scans, SPECT and x-ray among 750 patients being investigated for suspected coronary heart disease.

The study authors concluded that MRI was a “stronger predictor of risk for major adverse cardiovascular events, independent of cardiovascular risk factors, angiography result, or initial patient treatment.

It follows a series of papers that have contributed to the growing body of evidence that cardiac MRI is the best option for the diagnosis and management of patients with coronary heart disease.

In addition, it could also ease pressure on the NHS as only one hospital appointment is required for MRI, compared with two for SPECT, noted the researchers.

Woman in scanner MRI

Lead author Professor John Greenwood said: “Although SPECT is currently more widely available than MRI, the use of MRI across a wide spectrum of diseases means that it will be much more readily available for heart disease investigation in coming years.

“The benefits of cardiac MRI are not limited to reducing exposure to ionising radiation,” he said. “The non-invasive cardiac MRI test, which is not only more diagnostically accurate and cost effective for the NHS than SPECT, is also potentially better at forecasting the outcome of the disease.

“The outcomes of this study could lead to changes in clinical guidelines and to the way doctors investigate chest pain due to suspected heart disease,” he added.

Professor Peter Weissberg, medical director at the British Heart Foundation, which funded the study, said: “This research shows that MRI is the best non-invasive way to diagnose significant coronary heart disease in people with chest pain.

“Having an MRI scan does not involve radiation and the scanners are already widely available in heart centres across the UK, which should aid its rapid adoption in UK diagnostic guidelines,” he added.

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