SPECT is widely used to predict adverse cardiac events like heart attack or death in patients with suspected angina, but MR may be the better option, according to a study conducted by The University of Leeds in England.

It’s not only the most effective method, but it’s also the safest since no radiation is used.

"Cardiac MR is an excellent test for diagnosing significant coronary artery disease, and now we have shown that it is also very good at risk stratifying those patients into high and low risk groups," John Greenwood, professor of cardiology at The University of Leeds and lead researcher of the study, told HCB News.
Cardiovascular heart disease (CHD) is the leading cause of death worldwide and is responsible for 70,000 deaths in the U.K. each year, according to the British Heart Foundation. Most CHD deaths are caused by a heart attack.

When a physician suspects that a patient has angina, they will have them either undergo an X-ray angiogram, which is an invasive procedure that uses radio-opaque dye to see inside the arteries, or a SPECT exam — but both of those exams expose patients to radiation.

The researchers conducted a five-year, follow-up study on 752 patients from the Clinical Evaluation of MAgnetic Resonance imaging in Coronary heart disease (CE-MARC) study. Out of those patients, 628 underwent cardiac MR, SPECT and then X-ray angiography within four weeks.

The researchers followed up with the patients after five years to see if they had experienced any major adverse cardiovascular events. They found that at least 104 of them had.

After evaluating the data, the researchers concluded that cardiac MR is a stronger predictor of risks for major adverse cardiovascular events compared to SPECT. They added that the findings support the role of cardiac MR as an alternative to SPECT to diagnose and manage patients with suspected CHD.

Earlier evidence from the CE-MARC study found that MR is also more cost effective than SPECT for diagnosing CHD. In addition, only one hospital appointment is needed for MR, but two are required for SPECT.

"Cardiac MR should become more widely adopted, as it is also a very safe test, in that it doesn't use any [ionizing] radiation or nephrotoxic contrast agents," said Greenwood.

Even though SPECT is more widely used than MR, the researchers think that since MR is being used for a wide range of diseases, it will become more readily available for heart disease investigation in the near future. It also helps that MR scanners are readily available in heart centers across the U.K.

This new study is just a piece of the growing amount of evidence that cardiac MR is the best method to diagnose and manage patients with CHD. This research is expected to inform clinical guidelines for the investigation of stable CHD.

"Whether cardiac MR becomes a standard investigation in any particular country will depend on individual health care systems, reimbursement, scanner availability, and the availability of trained staff," said Greenwood. "In the UK and Europe, cardiac MR is already widely used for the investigation of patients with suspected cardiac chest pain."

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