How a 40-minute MRI could help patients with angina

A 40-minute MRI scan to test for angina can spare patients from invasive angiography along with an overnight stay in the hospital, according to a recent study published in the New England Journal of Medicine.

The MR-INFORM trial analyzed more than 900 patients with angina who underwent either invasive angiography or an MRI scan. While both groups had similar outcomes, those who underwent the 40-minute scan had far fewer procedures over the course of their treatment, reported lead researcher Eike Nagel MD, chair in Clinical Cardiovascular Imaging at King’s College London.

“Personalizing patients' treatment for angina will mean that we can target the more invasive treatments only to those patients that really need them,” Nagel added, in a prepared statement.

Angina is chest pain caused by reduced blood flow to muscles in the heart and is a warning sign for risk of heart attack. Patients are traditionally diagnosed with the condition using angiography, which involves x-rays of the arteries and numerous hospital visits. If the reduction in blood flow is serious patients are forced to undergo revascularization.

Nagel and colleagues divided 918 patients with angina and risk factors for coronary artery disease into two groups. The first underwent standard angiography while the other had a 40 minute MRI perfusion scan of the heart to determine whether or not they would need invasive angiography.

Both groups had similar health outcomes, with under 4% in each experiencing a cardiac event such as a heart attack at one-year follow up. Patients whose treatment was guided by MRI had “significantly” fewer procedures, and 48% went on to have invasive angiography, compared to 97% in the other group.

Additionally, 36% in the MRI group were recommended for revascularization, compared to 45% in the angiography cohort.

"We have shown that MRI imaging, which is less invasive than current diagnostic tests, could mean that patients' initial visits to hospital are quicker and more patient friendly, and that they are less likely to have further procedures,” Nagel explained. “But crucially the outcomes for patients of taking this approach were similar, so there is no negative impact of directing treatment in this way only to those we're sure need it.”