New technique to predict heart attacks
5 Jun 2012 by Evoluted New Media
A new imaging technique combining positron emission tomography (PET) and computerised tomography could help improve how doctors predict a patient’s risk of having a heart attack.
The research – from the Universities of Cambridge and Edinburgh and the British Heart Foundation (BHF) – highlights the disease processes causing heart attacks directly within the coronary arteries.
Researchers recruited 119 volunteers aged between 64 and 80 with and without aortic valve disease and used the standard calcium test to measure the amount of calcified plaques in their coronary arteries. While the test is commonly used to predict heart attack risk, it is unable to distinguish between previously built up calcium, and that which is actively building up.
Patients were also injected with two contrast agents; the first – 18F-Fluorodeoxyglucose (18F-FDG) – was used in imaging of atherosclerotic plaque inflammation by Cambridge researchers a decade ago. The second –18F-sodium fluoride (18F-NaF) – is taken up by cells in which active calcification is occurring. It can then be visualised and quantified during a PET scan.
“Predicting heart attacks is very difficult and methods we’ve got now are good but not perfect,” said Dr Marc Dweck, lead author and BHF Clinical Research Fellow. “Our new technique holds a lot of promise as a means of improving heart attack prediction.”
Researchers wanted to identify patients with active ongoing calcification as they may be at a higher risk of heart attack than those patients in whom calcium developed a long time ago. Their results – published in the Journal of the American College of Cardiology (JACC) – show that increased 18F-NaF activity could be observed in specific coronary artery plaques in patients who had many high-risk markers of cardiovascular disease.
“Our results show, for the first time, that certain areas of atherosclerosis within the coronary arteries, previously through to be inert, are actually highly active and have the potential to cause heart attack,” said Dr James Rudd, joint senior author from Cambridge.
“Once identified, they might be targeted with drug therapy more effectively. Additionally, we might be able to improve our ability to predict an individual person’s future risk of heart attack using this fairly straightforward imaging test in selected people.”
Coronary arterial 18F-sodium fluoride uptake; a novel marker of plaque biology
