Novel Scan May Predict Coronary Artery Disease, Heart Attacks

Researchers recently created an experimental type of imaging technique that provides advanced warning of coronary artery disease and heart attacks, according to a study published by Science Translational Medicine.

The authors expect that this novel imaging technique could be incorporated into computed tomography angiography (CTA) to speed diagnosis and management of coronary artery disease.

Coronary artery disease occurs when plaque builds up and narrows the arteries that transport blood to the heart. When the arteries become blocked, a heart attack occurs.

Current diagnostic techniques can only detect sustained damage that is irreversible, rather than precursors to the damage, according to the authors.

“Currently, CT scans can only identify people who have significant narrowings in their heart vessels. But by then the disease may have already caused damage which cannot be undone, and it is not possible to identify which narrowings might progress to cause a heart attack,” said lead researcher Charalambos Antoniades, MD, PhD.

It is well known that local inflammation precedes the development of plaques and also triggers the blockages that cause heart attacks. Detection of inflammation in coronary arteries has been an unmet diagnostic need, according to the study.

“The new scan offers the potential to find people at an earlier stage of disease and before the damage becomes irreversible,” Dr Antoniades said. “By providing an early warning of disease, the new imaging technique can be used by doctors as the trigger for more powerful treatments designed to reduce the risk of a future heart attack.”

In the study, the authors discovered communication between the heart’s arteries and the fat that surrounds them. Interestingly, the fat surrounding the arteries can predict inflammation from surrounding arteries, which was observed to change fat composition.

The investigational imaging technique—known as perivascular fat attenuation indexing—tracks the changes in fat surrounding inflamed arteries, even in cases where the narrowing of arteries is not visible, according to the study.

The technology also has the ability to detect if plaques are likely to form sudden blockages, which indicates a person is at an increased risk of experiencing a heart attack.

Determining whether a patient has inflamed arteries, but lacks narrowing, is expected to increase prevention measures to prevent heart disease, according to the study.

Additionally, determining if patients with heart disease have plaques prone to a heart attack can be used to direct patients to expensive therapeutic interventions available, according to the study. This will prevent waste and likely reduce drug costs.

“Developing methods that will enable clinicians to identify people whose vessels are in the early process of developing narrowings, and are at a high risk of causing a heart attack, has been a longstanding goal for research in cardiovascular disease,” said co-investigator Keith Channon, FMedSci, FRCP. “We’ve known that vascular inflammation drives both the earliest stages of coronary artery disease, and in the events directly preceding a heart attack, but until now we have had no way to easily detect inflammation in the coronary arteries. This new imaging technique can be applied to existing CT angiograms, without additional equipment, making it widely applicable.”