Cardiovascular MRI tops SPECT as predictor of future adverse cardiac events

Cardiovascular MRI is more effective than SPECT at predicting major adverse cardiovascular events in patients with suspected heart disease, according to results of a new study recently published in the Annals of Internal Medicine.

Noninvasive detection of coronary heart disease generally relies upon the two established imaging modalities. But there is a distinct lack of data comparing the predictive powers of the methods in patients suspected of having heart disease, said lead author John Greenwood, PhD, and his colleagues from the University of Leeds in England.

“[Cardiovascular MRI] is attractive because of its lack of ionizing radiation, high spatial resolution, and versatility in providing morphologic and functional cardiac assessment in a single study,” they wrote. “Data on the prognostic value of [cardiovascular MRI] remain limited, and there are no directly comparative prognostic data relative to other noninvasive imaging modalities in the same patient population.”

Greenwood and his team set out to assess the ability of cardiovascular MRI and SPECT to predict major adverse cardiovascular events. To do so, they conducted a follow-up study on 628 patients enrolled in the Clinical Evaluation of Magnetic Resonance Imaging in Coronary Heart Disease study (CD-MARC) suspected of having coronary heart disease using both modalities, then measured the number of adverse cardiac events and each imaging technique’s predictive performance.

They found that of all the patients studied, 16 percent had at least one major adverse cardiovascular events. While both procedures were strong and independent predictors of these problems, cardiac MRI proved to be more effective than SPECT at predicting future adverse cardiovascular events.

“Five-year follow-up of the CE-MARC study indicates that compared with SPECT, [cardiovascular MRI] is a stronger predictor of risk for [adverse cardiovascular events], independent of cardiovascular risk factors, angiography result, or initial patient treatment,” the authors concluded. “This further supports the role of [cardiovascular MRI] as an alternative to SPECT for the diagnosis and management of patients with suspected coronary heart disease.”