CT angiography and stress tests can predict heart attacks

Invasive angiography unnecessary?

Noninvasive CT angiography and CT myocardial stress perfusion imaging can adequately predict heart attacks and major adverse cardiovascular events, according to a study published yesterday in Radiologyno invasive coronary angiography (ICA) required.

Invasive coronary angiography (ICA), along with stress tests and single photon emission tomography (SPECT) imaging, has long been the "gold standard" for making determinations of whether a lesion is hemodynamically significant and likely to result in major adverse cardiovascular events, reads a Radiological Society of North America press release.

But this "gold standard" has its drawbacks—in costs and risk.

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AACC scientists identify new cardiac biomarker

Plus, get ready for high sensitivity cardiac Troponin assays in practice.

Laboratory medicine experts discovered a new lipid biomarker panel to detect heart failure with reduced ejection fraction (HFrEF) even before symptoms present, with "much greater certainty than standard tests for this condition," according to a January 5 press release from the American Association for Clinical Chemistry (AACC).

The January issue of the AACC's journal, Clinical Chemistry focuses on cardiovascular disease and features research reflecting a "growing understanding of the molecular signatures of heart disease," according to the press release, and a trend towards developing "more precise tests for the early diagnosis, monitoring, and targeted treatment."

The study in question identified three new cardiac lipid biomarkers, a cardiac lipid panel (CLP), which "significantly improved diagnostic performance" when combined with the current standard biomarker approach for diagnosing heart failure, NT-proBNP.

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One Minute, Shared Decision-Making Aid Reduces Unnecessary Hospitalization

Additional cardiac imaging often unnecessary

Last week, Mayo Clinic researchers showed that using a shared decision-making aid to involve more patients in care decisions can prevent both unnecessary hospitalization and more advanced cardiac tests for patients with low-risk chest pain.

The "Chest Pain Choice" shared decision-making aid is one of the latest evidence-based practices built on high-sensitivity troponin rule-out of acute coronary syndrome for ED patients reporting acute chest pain. After the one-hour test, an additional "one minute" discussion to educate patients about their risk and reach a shared decision can prevent further unnecessary and costly testing.

ACVP Blog has discussed decision-making for acute chest pain before, suggesting that the fact the cardiac biomarker test can safely and accurately rule-out acute coronary syndrome within one hour "challenges [the] need" for commonly-used noninvasive imaging prior to patient discharge.

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Cath innovation: Cardioband repairs first leaky tricuspid

Valtech Cardio's Cardioband system brings direct annuloplasty to the field of percutaneous coronary intervention—for catheter-based mitral valve repair and now, tricuspid valve repair.

A team from the University Hospital Zurich led by Francesco Maisano, MD recently succeeded in the first ever minimally invasive procedure using Cardioband to repair a leaky tricuspid valve, according to yesterday's press release from the University of Zurich.

The news comes shortly after Valtech shared follow-up data from a multi-center Cardioband Mitral study at the PCR London Valves 2016 conference. Results showed a "significant and consistent reduction in MR" with a "safety profile similar to equivalent transcatheter procedures" according to the session slides.

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