By Mark Waghorn

High-tech scans can identify patients at risk of a heart attack – years before they might happen, according to new research.

The method called “radiomics” combines data from CT (computed tomography) that reveal signs of disease not visible in the images alone. It spots deposits of fat in artery walls that could cut off the organ’s blood supply.

The large “plaques” rich in lipids such as bad cholesterol cause most heart attacks. They sometimes rupture – but predicting it is challenging. Co-lead author Dr. Long Zhang, of Nanjing University, said: “The results of this study are encouraging and exciting.

Angiography of myocardial infarction affected by atheromatous plaque in the left coronary artery. Angiographic visualization is produced by injection of contrast product. CAVALLINI JAMES/GETTY IMAGES

“Radiomics provided a more accurate approach to detect vulnerable plaques compared to conventional coronary CT angiography anatomical parameters.”

It is a potential gamechanger – enabling statins or other protective drugs to be prescribed at the earliest opportunity. The Chinese team developed a model based on information from the CT scans of around 300 individuals.

It enabled the detection of life-threatening clots in just over 700 patients with suspected coronary artery disease. A “high radiomic signature” was independently linked with potential heart attacks over an average follow-up period of three years.

It would be easy to add into practice – helping classify those likely to suffer such an event in the future.

Dr. Zhang said: “If the radiomics analysis is embedded into the routine CT angiography workstation, it can automatically identify vulnerable plaques for clinician review.

“Thus, radiomics may significantly improve the accuracy and precision of high-risk plaque detection in routine clinical practice.”

Heart attacks affect 100,000 people in the UK annually. CT scans are offered to about 40,000 Britons a year.

Dr. Zhang’s system would enable hundreds of thousands of over 40s to undergo them – particularly smokers, diabetics and those who are overweight.

Previous research has suggested one-in-ten of those given the all-clear are at risk of a heart attack because of plaques that have not been picked up by regular CT.

IN FILE – Patrick Dary, cardiologist in Saint Yrieix La Perche, presents the first heart exploration by remote cardiac ultrasound in Lubersac on November 25, 2015. PASCAL LACHENAUD/GETTY IMAGES

Dr. Zhang and colleagues are now building a radiomics model from different scanner types and vendors. They are also planning a larger study of 10,000 patients.

He said: “With the support of large observational studies and randomized controlled trials, the radiomics approach may help guide clinical decision-making and improve patient care in the future.”

The study was published in the journal Radiology.

Produced in association with SWNS Talker.

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