Scans needed to save ‘ticking time bomb’ heart patients

The Times

Chris Smyth, Health Editor

Gerry Gajadharsingh writes:

 “Coronary CT scans have been used in the private sector for at least 15 years. Giving an indication of the “hard” plaque that has formed in the coronary arteries and a calcium score gauging the “hardening” of the coronary arteries. The article does not say which new biomarkers are being measured on the new enhanced CT scans, but it seems that using technology to enhance what the CT is showing, may well be very useful in picking up an additional 10% of patients (who were previously thought to be healthy) and who may be at increased risk from a cardio-vascular event. As always, it’s important to use diagnostics to help people improve lifestyle, not to scare them and for those at high risk to offer appropriate medical management.”

 

Hundreds of thousands of patients should get scans to pick out those who have a nine times higher risk of dying of a heart attack, a study has concluded.

Spotting vital changes in fat surrounding blockages in the arteries will save lives by identifying patients most at risk of fatal illness, researchers say. The “transformative” scans should be used to pick out patients who do not know they are at much higher risk and offer them more aggressive treatment.

About 40,000 patients a year get CT scans for problems such as chest pain and this is already predicted to increase to 300,000 under guidance for diagnosis of coronary heart disease.

About 80 per cent are told that they are healthy, but the latest study suggests that more than one in ten of the supposedly healthy patients are at high risk of heart problems. The new test involves extra analysis of the scans to identify chemicals released by the most dangerous artery plaques, potentially spotting thousands more at risk.

The study of 1,900 people found that 3.5 per cent of those identified as highest risk died from heart problems over five years, nine times the rate of those it put at lowest risk. In further tests on 2,000 separate patients, the high-risk patients were almost six times as likely to die.

“This new technology may prove transformative,” Charalambos Antoniades, a professor of cardiovascular medicine at Oxford University, said. “Knowing who is at increased risk for a heart attack could allow us to intervene early enough to prevent it. I expect these biomarkers to become an essential part of standard CT coronary angiography reporting.”

About 100,000 people in Britain die each year after a heart attack. Metin Avkiran, associate medical director at the British Heart Foundation, which funded the research, said: “Most heart scans are good at spotting blockages caused by large plaques, but not the smaller, high-risk plaques that are likely to rupture and cause a heart attack. This new technique could be a game changer — allowing doctors to spot those “ticking time bomb” patients who are most at risk of a heart attack.”

CT scans cost the NHS about £100 and Professor Antoniades said that the new method would be used for “potentially everybody who has a CT scan of their heart arteries anyway, as part of current clinical practice. The difference now is that with the new technology you identify an extra 10 per cent of the ‘healthy’ people who are not healthy, and they don’t know it.”

2018-09-10T13:26:17+00:00