An
award-winning research project, funded by the British Heart Foundation (BHF),
has tested a new imaging method which could help improve how doctors predict a
patient's risk of having a heart attack.
Scientists from the University of Edinburgh, a BHF
Centre of Research
Excellence, in collaboration with the University of Cambridge are the first
to demonstrate the potential of combining PET and CT scanning to image the
disease processes directly in the coronary arteries that cause heart attacks.
There are nearly 2.7 million people living with coronary heart
disease (CHD) in the UK and it kills 88,000 people each year. Most of
these deaths are caused by a heart attack. Each year
there are around 124,000 heart attacks in the UK.
The research, published in the Journal
of the American College of Cardiology(JACC), involved giving
over 100 people a CT calcium score to measure the amount of calcified or
hardened plaques in their coronary arteries. This is a standard test, which is
commonly used to predict CHD risk but cannot distinguish calcium that has been
there for some time from calcium that is actively building up.
The patients were also injected with two tracers,
special molecules that show up on certain imaging scans and can be used to
track substances in the body.
One of these tracers, 18F-sodium fluoride (18F-NaF),
is a molecule taken up by cells in which active calcification is occurring. The
18F-NaF can then be picked up and measured on PET scans.
The researchers wanted to see if they could identify
patients with active, ongoing calcification because these patients may be at
higher risk than patients in whom the calcium developed a long time ago.
The results showed that increased 18F-NaF activity
could be observed in specific coronary artery plaques
in patients who had many other high-risk markers of cardiovascular disease.
Dr Marc Dweck, lead author on the research paper and
a BHF Clinical Research Fellow at the University of Edinburgh, said:
"Predicting heart attacks is very difficult and
the methods we've got now are good but not perfect. Our new technique holds a
lot of promise as a means of improving heart attack prediction although further
ongoing work is needed before it becomes routine clinical practice.
"If we can identify patients at high risk
of a heart attack earlier, we can then use intensive drug treatments, and
perhaps procedures such as stents, to reduce the chances of them having a heart
attack."
Dr Shannon Amoils, Research Advisor at the (BHF),
which funded the study, said:
"For decades cardiologists have been looking
for ways to detect the high-risk plaques found in coronary arteries that could
rupture to cause a heart attack, but it's been difficult to develop a suitable
imaging test that can focus in on these small vessels.
"This research is a technical tour de force as
it allows us to assess active calcification happening right in the problem area
– inside the wall of the coronary arteries and this active calcification may
correlate with a higher risk of a heart attack."
The research follows on from recent work Dr Dweck
did using PET/CT that provided greater insight into the aortic valve disease –
aortic stenosis. With the support of the BHF, Dr Dweck and his colleagues at
Edinburgh also intend to translate this technique into predicting a patient's
risk of a stroke.
More
information: Dweck M et al (2012). Coronary arterial
18F-Sodium Fluoride Uptake. Journal of the American College of
Cardiology. Currently available online: http://content.onl … t/59/17/1539
Information about this research is available here: http://www.bhf.org
… x?page=14021
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