Although advanced imaging exams have proven benefits in defining disease severity, new data indicate that more sophisticated studies might not impact outcomes as much as previously thought, at least when it comes to heart failure.
This finding was presented by Lisa Mielniczuk, MD, of the University of Ottawa Heart Institute in Canada, earlier this month at the American College of Cardiology (ACC) annual meeting. Mielniczuk shared the results of the AIMI-HF trial (Alternative Imaging Modalities in Ischemic Heart Failure) during her presentation.
For the study, 1,069 patients underwent CMR or PET and 312 underwent imaging with SPECT. Eligibility hinged on patients having known or suspected coronary artery disease, history of myocardial infarction and/or moderate ischemia.
In the trial, experts concluded that when revascularization is being considered for patients who have heart failure with reduced ejection fraction (HFrEF) and known or suspected CAD, the addition of advanced imaging, such as cardiac MRI (CMR) or PET scans, does not have a significant impact on outcomes. With the primary endpoint being cardiac death, myocardial infarction (MI), resuscitated cardiac arrest or cardiac hospitalization, outcomes were similar between those who underwent additional advanced imaging (31%) and those who underwent SPECT imaging alone (35%). This was despite those who received CMR or PET undergoing early revascularization significantly more often than those who underwent SPECT (32% vs 12%).
These findings were similar in patients who underwent advanced imaging for ischemia, though notable reductions were noted in cardiac death rates between patients who underwent PET imaging compared to SPECT alone (11% compared to 18.6%).
“Our study found no significant differences in the primary cardiovascular composite between the advanced and SPECT imaging groups. We saw this in the total study population as well as in the randomized cohorts,” Mielniczuk noted in her presentation.
To learn more about the study results, click here.