A new imaging technique can predict the risk of a second heart attack or death better and more quickly than the widely used exercise stress test, researchers reported on Monday.
The technique, vasodilator perfusion imaging, can be done on a patient as soon as two to four days after a heart attack, Dr. Kenneth Brown and colleagues at the University of Vermont reported in the journal Circulation.
"I think this is something that should be much more widely applied," Brown said in a statement. He said a smaller hospital could more easily do the perfusion scan than a stress test.
And it could save money, he and other experts said. "Substantial cost savings can be realised in appropriate patient populations," Dr. Frans Wackers, director of the cardiovascular imaging and exercise laboratories at Yale University School of Medicine, wrote in a commentary.
Brown and colleagues looked at 451 patients. Some were given the new imaging test two to four days after their heart attacks and then also had an exercise stress test six to 12 days later, while others got the exercise test alone.
In vasodilator perfusion imaging, patients first get an infusion of a drug called dipyridamole, which increases blood flow through the heart. Then they are infused with a mildly radioactive imaging agent, which helps doctors see blood flow using single photon emission computed tomography (SPECT).
The researchers said this is less of a strain to a patient than being forced to walk on a treadmill with electrodes glued to the chest.
His team found that patients whose SPECT images showed they had only small or intermediate areas of permanent heart damage had less than a one percent risk of a second heart attack over the next year. The more muscle damage, the greater the risk of another heart attack, they found.
But the stress test did not predict who would have a heart attack, Brown reported.
Copyright 1999 Reuters Limited.
