Patients may no longer need to endure invasive procedures to investigate mild heart attacks, according to a new study from Flinders University in South Australia.
If a randomised control trial (RCT) is successful, the CT scan could become a preferred tool for doctors which could also reduce the risk of complications.
Although the procedure only takes around 40 minutes, medical staff must monitor things like blood pressure, the pulse, breathing, and wound site regularly afterwards, with the patient needing up to six hours before being discharged.
There are also a bevy of potential complications from the procedure including bleeding from the wound, allergic reaction to the contrast dye, heart arrythmia, heart attack, and stroke.
“This is despite the fact that most patients with lower levels of troponin are not found to need surgery to reduce or remove a blockage," he said.
The Trial and Expected BenefitsThe RCT will involve 3,000 patients and evaluate the safety of first-line investigations carried out by a non-invasive CT coronary angiography (CTCA) compared to an invasive coronary angiography (ICA).
In addition, the trial will assess whether a CT angiography is a more suitable method with regards to bleeding, the potential for heart muscle injury and patient satisfaction.
Through the trial, a machine learning algorithm will also be created to assist clinicians in deciding which diagnostic technique is most appropriate for each patient.
Lehman said the overall aim of the trial is to advance the evidence base for these procedures, as well as facilitate their translation into practice and policy.
“Alongside a reduction in health care costs, there is potential for early CT coronary angiography to be a non-invasive alternative to ICA, leading to a reduction in ad hoc revascularisations (surgery to unblock the heart), reducing the potential for patient harm and providing for more accessible treatment throughout Australia," he said.
“Rural and remote areas often have less access to cardiac expertise that can inform care, with only 11.5 percent of cardiologists located in these geographic regions, despite 28 percent of Australia’s population living in these areas, potentially driving inappropriate treatment.
“Changing the standard of care could drive more appropriate access to acute cardiac investigations and equitable health outcomes in regional and remote areas.”