Heart attack, stroke risk in diabetic patients predicted by MRI

Whole-body MRI could be used as an accurate, noninvasive tool for predicting the risk of heart attack and stroke in patients with diabetes, according to a study published online in Radiology.

“The extent of cardiovascular disease as detected with whole-body MR imaging in patients with diabetes mellitus has strong prognostic implications, independent of other established clinical or laboratory markers,” wrote Fabian Bamberg, MD, MPH, of Ludwig-Maximilians University in Munich, and colleagues.

Previous studies have shown diabetic patients are more likely to develop atherosclerosis at an accelerated rate, leading to a greater risk of major adverse cardiac and cerebrovascular events (MACCE), such as heart attack or stroke.

To help determine MRI’s predictive value in assessing MACCE risk in individual patients, Bamberg and colleagues conducted a study involving 65 patients with diabetes who all underwent a contrast-enhanced whole-body MRI protocol, including brain, cardiac and vascular sequences.

Follow-up information was available for 61 patients, and the results showed that after a median follow-up of 5.8 years, 14 patients (23 percent) had experienced MACCE. Patients with detectable vascular changes on MRI had a cumulative MACCE risk rate of 20 percent at three years and 35 percent at six years, while none of the patients with a normal whole-body MRI experienced MACCE.

“As a summary measure of findings at whole-body MR imaging, each pathologic vascular territory portrayed an approximately threefold higher risk for future adverse events,” wrote the authors.

Imaging could bring early treatment to those at risk of heart attack or stroke, and MRI is particularly well-suited for this purpose since it is not associated with radiation exposure and can target larger body areas. MRI can also detect cerebral and vascular changes, such as restriction of blood flow to the brain, according to Bamberg.

“Our study provides preliminary evidence that the technique may be beneficial for risk stratification in patients with diabetes,” Bamberg said in a press release. “We anticipate that emerging study findings in different diabetic cohorts will provide additional scientific basis to establish whole-body MRI as a screening modality.”