Improving the prediction of heart attacks

“Our study shows that we can detect more dangerous, hidden, non-calcified plaques. This is the first major study in the world to show that coronary CT angiography can help us identify people at high risk of, for example, a heart attack – people who have not previously had a heart attack or stroke but are at increased risk and therefore need effective preventive measures,” says Göran Bergström, Senior Consultant at Sahlgrenska University Hospital, professor at the University of Gothenburg and principal investigator of SCAPIS.

Current methods for assessing cardiovascular risk are based mainly on factors such as age, sex, smoking, blood pressure and blood lipid levels. CT scans can also detect calcification in the coronary arteries, providing additional information about cardiovascular risk. However, conventional calcium scoring does not detect non-calcified plaques, which may also contribute to coronary artery disease.

Researchers have now investigated whether a more detailed CT scan of coronary arteries can provide a more accurate assessment of risk in otherwise healthy, middle-aged people. The study found that adding coronary CT angiography improved the ability to predict who was more likely to experience a heart attack during the eight-year follow-up period.

The findings could pave the way for earlier identification of people at high risk and, in the future, more targeted preventive treatment and lifestyle interventions. Further studies will investigate how the method can be refined, including with the help of artificial intelligence, and which patient groups are most likely to benefit.

“Our conclusion is that coronary CT angiography improves our ability to predict heart attacks. There is no doubt that some individuals could benefit from additional coronary CT angiography,” Göran Bergström continues.

SCAPIS – a major Swedish research study

SCAPIS (Swedish CArdioPulmonary bioImage Study) is a large population-based study focusing on heart, blood vessel and lung disease. Funded primarily by the Swedish Heart-Lung Foundation and led by researchers from six Swedish universities and university hospitals, among them Sahlgrenska University Hospital, the study has involved 30,000 randomly selected people aged 50–64.

Participants underwent extensive examinations, including CT imaging, ultrasound, lung function tests and blood tests, as well as assessments of physical activity and lifestyle. The collected data, blood samples and images form a national research resource used to improve the prevention, diagnosis and treatment of cardiovascular and lung disease.

A follow-up study, SCAPIS 2, is being carried out between 2024 and 2026, with 15,000 participants invited to undergo largely the same examinations. This will help researchers understand how cardiovascular and lung disease develop over time and support the development of more precise methods for preventing and treating disease.

Study

Coronary Computed Tomography Angiography in Prediction of First Coronary Events 
 
Source: Swedish Heart Lung Foundation