Use Of Angiography High Among People With Suspected Coronary Heart Disease

University of Leeds, United Kingdom researcher, John P. Greenwood, Ph.D., and colleagues examined whether among patients with suspected coronary heart disease (CHD), cardiovascular magnetic resonance (CMR)-guided care is superior to National Institute for Health and Care Excellence (NICE) guidelines-directed care and myocardial perfusion scintigraphy (MPS)-guided care in reducing unnecessary angiography. This study was published online by JAMA.

The study is being released to coincide with its presentation at the European Society of Cardiology Congress 2016.

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‘Avoiding unnecessary angiography among patients with suspected CHD by using CMR guided strategy will help reduce patient risk and provide significant financial savings.’

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Coronary heart disease is a leading cause of death and disability worldwide. Several methods are available to diagnose CHD, risk-stratify patients, and determine the need for revascularization.

Despite the widespread availability and recommendations for noninvasive imaging in international guidelines, invasive coronary angiography is commonly used in patients with suspected CHD.

Evidence from large populations presenting with chest pain has confirmed that the majority will not have significant obstructive coronary disease. Avoiding unnecessary angiography should reduce patient risk and provide significant financial savings.

Obesity for a Prolonged Period Enhances the Risk of Coronary Heart Disease
Obesity, in young adults, results in the accumulation of calcium deposits in the blood vessels of the heart. The risk of coronary heart disease is enhanced by 2-4% with each year of obesity.

In this study, 1,202 symptomatic patients from 6 UK hospitals with suspected CHD were randomly assigned to management according to UK NICE guidelines (n = 240) or to guided care based on the results of CMR (n = 481) or MPS (n = 481) testing.

Among the patients, the number with invasive coronary angiography after 12 months was 102 in the NICE guidelines group (43%), 85 in the CMR group (18%); and 78 in the MPS group (16%). The researchers found that a CMR-guided strategy significantly reduced study-defined unnecessary angiography compared with NICE guidelines-guided care, but was not significantly different from an MPS-guided strategy.

CT Angiography Can Hasten the Diagnosis of Heart Ailments
Recently coronary computed tomography angiography has emerged as an effective diagnostic tool to image the coronary arteries. Prof. Hoffmann analyzed its effectiveness against the standard protocol.

Between the 3 strategies, there was no difference in major adverse cardiovascular event rates at 12 months or disease detection (positive angiography) rates.

First Nations People Less Likely to Receive Guideline-Recommended Angiography After Heart Attack
After a heart attack, First Nations people are less likely to receive guideline-recommended angiography, compared with non–First Nations people and have poorer long-term survival rates.

Source-Medindia