Immediate use of the coronary CT scan – a low-invasive diagnostic test that allows you to produce high-definition 3D images of the coronary arteries and evaluate them – is a promising strategy for a more immediate diagnosis in patients with suspected ischemic heart disease, a serious disease related to a high risk of heart attack and death. This is demonstrated by an international study, just published in Annals of internal medicine, coordinated by the Cardiology team of the Gemelli Polyclinic in Rome, directed by Francesco Burzotta.
It is a large meta-analysis study – whose first author is Andrea Zito, a young cardiologist in training at the Gemelli – which collects all the scientific data currently available on the subject to evaluate which is the best method, as a first approach, to frame patients with suspected ischemic heart disease. This is a heart disease that affects the coronary arteries, making them unable to supply blood and oxygen to the heart due to progressive narrowing of the lumen. The evolution to be prevented is towards the acute occlusion of the artery, an event which can lead to a myocardial infarction. This pathology, Burzotta explains to ANSA, “is the main cause of death in Western countries and is the first cause of expenditure for the Health Service. The risk of getting sick increases with age. It has a great clinical impact, because promptly identifying and treating patients at greatest risk through angioplasty or coronary artery bypass surgery can improve the quality of life and in many cases their survival”.
Historically, faced with patients with suspected ischemic heart disease, the expert clarifies, “the first approach was to use non-invasive functional tests such as stress test or ultrasound and stress or pharmacological stress scintigraphy. Another approach, at the opposite extreme, was to directly perform the coronary artery CT scan, which is however an invasive examination.In recent years, thanks to the improvement of technologies, the new approach of coronary CT has instead established itself as a possibility. verified what were the signals that emerged from all the studies carried out so far comparing these different approaches. And from our study it emerged that the strategy based on the use of coronary CT has been shown to lead to a reduction in adverse events”.
It is, he says, a “major paradigm shift. The CT scan was in fact found to be better than the functional tests in preventing the risk of death and heart attack linked to the disease; compared to the coronary artery, the CAT scan was found to be comparable in terms of reducing the risk of adverse events. However, CT implies a lower need for interventional revascularization procedures of the patient, and this translates into less invasiveness on the patient as well as a reduction in costs borne by the health service”. This study, concludes Burzotta, allows us to hypothesize an evolution in the management of ischemic heart disease in which the different diagnostic approaches (functional, non-invasive anatomical, invasive anatomical) involve multidisciplinary teams and are proposed on the basis of the specific needs of the patient”.
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