Research presented at the British Cardiovascular Society (BCS) Conference has proven that a wire inserted into an artery which supplies blood to the heart, called a coronary artery, after someone has a heart attack can predict if they will go on to develop heart failure.
The study, from the University of Glasgow and funded by the British Heart Foundation (BHF) uses a pressure- and temperature-sensitive wire which can be used to accurately work out the extent of injury in a blood vessel supplying blood to the heart. They discovered that this test - known as the index of microvascular resistance or IMR - can be used to predict if someone is likely to go on to develop heart failure or even die.
There are around 175,000 heart attacks in the UK each year1 - one every three minutes. For those who survive a heart attack there is a risk that the heart will have been damaged and this can lead to heart failure. Heart failure can have a huge impact on a person's life, leaving them tired, short of breath and unable to do simple tasks like walk or take a shower by themselves. Early treatment following a heart attack can reduce the chance of heart failure and improve a person's wellbeing and chances of survival.
After a suspected heart attack, a patient is routinely given a coronary angiogram to identify any narrowed blood vessels. An angiogram visualises the affected blood vessels using a catheter threaded towards the heart from a distant blood vessel in the arm or leg. Currently, cardiologists make treatment decisions based on this standard assessment technique but it can only identify narrowed vessels and cannot tell the doctor if, or how much, heart blood vessel damage has occurred.
The wire technique can be used to work out the level of damage to the arteries in a matter of minutes. This allows doctors to quickly and accurately identify patients who are at a high risk of heart failure after their heart attack based on the damage to their arteries.
The patients who took part in this new research were enrolled in the Golden Jubilee National Hospital. All heart attack patients were eligible to take part to allow the findings to be applied to all heart attack patients in the future. Patients who took part in the project will have life-long follow-up to see if the IMR result predicts survival in the long term. The BHF also funded this follow-up so that the patients' long-term health can be assessed.
Professor Colin Berry, lead researcher and cardiologist from the University of Glasgow and Golden Jubilee National Hospital, said:
"Heart attacks lead to heart failure which is a big problem in the UK, and has a huge impact not only on the individual, but on the families and carers of those suffering - affecting whole communities.
"Thanks in large part to the work of the British Heart Foundation, 70 per cent of people who have a heart attack now survive, but this means we now see an increased number of people surviving but left with damaged hearts and heart failure.
"We want to improve the outlook for people after they have a heart attack and develop new treatments to limit heart damage, reducing the burden of heart failure."
The pressure wires used in this study were supported by funding from the Golden Jubilee National Hospital and the Chief Scientist Office of the Scottish Government.
Professor Jeremy Pearson, Associate Medical Director at the BHF, which funded the study, said:
"More and more people are surviving heart attacks due to the huge advances we've made in cardiology, but that isn't the end of the story. A heart attack causes damage which can leave a person facing a horrendous daily struggle.
"If we can identify the people at greatest risk of developing heart failure following a heart attack, and treat them more quickly, we could reduce the effects that these terrible events can have on individuals and communities. What we need now is for the public to help us fund more research to find possible new treatments for people with heart failure."