Coronary artery disease

Coronary atherosclerosis and myocardial infarction are a major global cause of morbidity and mortality. Our research seeks to improve our pathological understanding and to improve patient assessment, care and clinical outcomes using multi-modality state-of-the-art imaging technique.

Overview

CAD diagnosis

Since 2012, we have been looking to improve the diagnostic accuracy of angina due to coronary artery disease, using the very latest generation of computed tomography (CT) scanners.

In 2015, we completed the SCOTHEART trial. It was the first-ever trial to determine whether advanced CT scanning could help diagnose people who present with chest pain. For the first time, we showed that CT scanning:

markedly improves clarity of diagnosis
changes how people are treated
reduces the risk of subsequent heart attack by ~50%

This seminal paper was published in the Lancet in 2015. The work has received widespread media & scientific coverage, also winning a number of prizes.It has changed the NICE guidance on how doctors should investigate patients with suspected angina. Five year follow up study for SCOT-HEART published in NEJM which demonstrated beneficial impact of cardiac CT engiography, within the initial workup for chest pain symptoms.

We have also pioneered coronary 18F-fluoride PET-CT imaging which provides and assessment of disease activity to complement the anatomical information provided by CT. The PREFFIR trial will assess whether this imaging modality can improve patient risk stratification and the identification of patients at highest risk of future myocardial infarction.

CAD causes

We have described a highly innovative approach using positron emission tomography (PET), to identify fatty deposits or “plaques” in heart arteries & which are “vulnerable” to causing a heart attack.

This imaging approach uses a molecular tracer, which specifically binds to areas of inflammation & damage within the “vulnerable” plaque of the coronary artery. This molecular tracer emits a unique anti-matter (“positron”) signal, which can be detected by the specialised PET scanner. We can then localise the “vulnerable” plaque to within 3-4mm sections of the coronary artery.