New scan tells if bypass is needed

AN ultra-fast, 320-detector computed tomography (CT) scanner can accurately sort out which people with chest pain need – or don’t need – an invasive procedure such as cardiac angioplasty or bypass surgery to restore blood flow to the heart. The findings from the CORE 320 study, which involved 381 patients at 16 hospitals in eight countries, were presented at the European Society of Cardiology Congress in Munich on August 28.

It is the first prospective, multi-centre study to examine the diagnostic accuracy of CT for assessing blockages in blood vessels and determining which of those blockages may be preventing the heart from getting adequate blood flow, says senior study author Joao A. C. Lima, M.D.

"We found an excellent correlation in results when we compared the 320-detector CT testing with the traditional means of assessment usinga stress test with imaging and cardiac catheterisation,” said Dr Lima, a professor of medicine and radiology at the Johns Hopkins University School of Medicine.

 The study findings would apply to people who have chest pain but are not having a heart attack. Many people in that situation are sent to a cardiac catheterisation laboratory for further evaluation with angiography, and about 30% of people who have such catheterisation are found to have minimal disease or no blockage requiring an intervention to open or bypass the vessel.

SPECT compared to advance CT

The 381 patients who completed the study had traditional SPECT tests and invasive angiography. Dr Lima explained that SPECT shows reduced blood flow to the heart without indicating the number or specific location of blockages.

Study participants also had two types of tests with a non-invasive 320-detector CT scanner. The first test evaluated CT Angiography (CTA), wherein the scanner was used to see the anatomy of vessels to assess whether and where there were blockages. Then in a second test Air Jordan