More than a decade in the making, a collaboration between the University of Oxford, Erlangen in Germany and the Cleveland Clinic in the USA has published a breakthrough study in The Lancet journal this week. The team at the University of Oxford has developed a way of measuring coronary inflammation, allowing doctors to better detect the inflamed plaques of the coronary arteries that are most likely to block the blood supply and cause a fatal heart attack.
The technology uses a new imaging biomarker, called the perivascular Fat Attenuation Index (FAI), which allows the mapping of spatial changes in the perivascular fat surrounding major coronary arteries. This index was based on the analysis of computed tomography (CT) coronary angiograms, commonly used and non-invasive X-ray CT scans that involve the injection of a contrast dye, allowing the imaging of vessels and tissues.
Professor Metin Avkiran, the Associate Medical Director at the British Heart Foundation, which funded the research along with the NIHR Oxford Biomedical Research Centre, 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, and getting them on to intensive treatment. This would undoubtedly save lives.
‘By using this non-invasive scan, we could prevent a lurking heart attack that might occur down the road. But it also potentially gives us a real-time window into tracking the effect of drugs on inflamed arteries, helping us to identify new life-saving therapies.’
The paper reports an investigation into the efficacy of the indexinvolving 3,900 patients from across the world. It showed that patients with FAI that was above the boundary had up to nine times higher risk of having a fatal heart attack in the next five years.
Since heart attacks and related strokes claim the lives of over 100,000 people every year in the UK, a method that allows medical prevention therapy to be targeted to those with the greatest risk is very exciting. A spinout company from the University of Oxford will present the FAI to the healthcare sector as a Software-as-a-Service offering so it can begin to improve the preventative treatment of high-risk patients.