A trial evaluating 3T magnetic resonance imaging for diagnosing coronary heart disease

Clinical Evaluation of 3T MAgnetic Resonance imaging for the management of patients with Coronary heart disease: the CE-MARC 2 study

Under current best clinical practice guidelines, people with suspected coronary heart disease (CHD) undergo diagnostic tests including imaging scans. For many this will include an invasive coronary angiogram where the doctor injects a dye directly into the coronary arteries to find out if CHD is present and whether severely narrowed coronary arteries are limiting blood flow. The patient may go on to have coronary angioplasty or a bypass operation to improve blood flow to the heart muscle. Currently about 50% of angiograms find that angioplasty or a bypass operation are not needed. Also, coronary angiography can cause serious complications in a few patients so there is a need to identify better non-invasive tests for diagnosing people with CHD. In this clinical trial Dr John Greenwood is evaluating one of these tests – magnetic resonance imaging (MRI) scanning. Dr Greenwood’s team will test whether MRI can diagnose CHD more accurately than the other imaging tests currently used. If successful, MRI should lead to fewer unnecessary angiograms. They will recruit 1,200 patient volunteers with suspected CHD at hospitals in Leeds, Leicester and Glasgow. Half will be randomly assigned for diagnosis using current best clinical practice guidelines. The other half will have their care directed by the results of MRI scans. The researchers will see how many patients in each group go on to have angiograms and whether those patients end up having coronary angioplasty. The trial is the first of its kind and could, if successful, eventually lead to a change in clinical practice that reduces the number of angiograms carried out by the NHS.