This week, the first international consensus document to provide guidelines for MRI studies during clinical trials after a patient has suffered a myocardial infarction (also known as a heart attack) has been published in the Journal of the American College of Cardiology (JACC).
Coordinated by cardiologists at the Centro Nacional de Investigaciones Cardiovasculares (CNIC), a leading international research center in Madrid, Spain, the guidelines were defined by a team global experts, supported by Philips.
MRI is increasingly used to assess the heart after a myocardial infarction, gauging a patient’s risk for future events, understanding the changes taking place in cardiac tissue and evaluating treatment options. By supporting a more consistent application of cardiac MRI during clinical and experimental trials and making their results more easily comparable, the document’s authors believe the recommendations will have a significant positive impact.
The document concludes that the main outcome parameter in studies assessing new treatments should be absolute infarct size, i.e. the percentage of the left ventricle (heart chamber) that is irreversibly damaged. The guidelines also recommend that the MRI study should be carried out between three and seven days after the infarction. They also address the need within the cardiovascular community for guidance on the best protocols, the best techniques, and the most appropriate situations for conducting MRI studies after a myocardial infarction.
The lead scientists for the consensus document are Dr Borja Ibañez, Clinical Research Director at the CNIC, consultant cardiologist at Fundación Jiménez Díaz hospital, and a member of the CIBERCV cardiovascular research network; and Dr Valentín Fuster, Director of the Cardiovascular Institute and Medical Director at Mount Sinai Hospital in New York.
“Magnetic resonance imaging is one of the best methods for studying the heart after an infarction,” said Dr Fuster. “It allows the study of heart anatomy, function, and tissue composition in a very precise way without exposing the patient to radiation. Magnetic resonance imaging is the ideal method for assessing the effect of new treatments. However, until now the community has lacked consistent recommendations on the specific procedures to follow after an acute myocardial infarction in order to assess the effect of these treatments.”