INTERVENTIONAL STRATEGIES GUIDED BY DYNAMIC PERFUSION CMR AND CT CORONARY ANGIOGRAPHY IN SUSPECTED CAD: A STUDY FROM PAKISTAN
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Keywords
Coronary Artery Disease, Dynamic Perfusion CMR, CT Coronary Angiography, Percutaneous Coronary Intervention, Pakistan, non-invasive imaging, cardiac care.
Abstract
Background: Coronary Artery Disease (CAD) remains a major health challenge worldwide particularly in Pakistan, where it significantly contributes to morbidity and mortality. This study investigates the effectiveness of Dynamic Perfusion Cardiac Magnetic Resonance Imaging (CMR) and CT Coronary Angiography (CCTA) in diagnosing and guiding interventions for CAD in a resource-limited setting.
Methods: Conducted at Lady Reading Hospital, Peshawar, this prospective cohort study enrolled 50 subjects with suspected CAD from January 2020 to December 2021. Participants underwent Dynamic Perfusion CMR and CCTA, followed by Percutaneous Coronary Intervention (PCI) based on imaging outcomes. Data were analyzed using SPSS v25.0 to determine the diagnostic accuracy and predictive value of these imaging techniques.
Results: The combined use of Dynamic Perfusion CMR and CCTA demonstrated high diagnostic accuracy (sensitivity 95%, specificity 98%) for significant coronary stenosis. Of the participants, 32 displayed moderate to severe stenosis on CCTA, and 28 underwent PCI with a high success rate. The integration of these non-invasive imaging modalities significantly influenced management decisions and intervention strategies.
Conclusion: Dynamic Perfusion CMR and CCTA are effective for diagnosing and guiding treatment of CAD in Pakistan, offering a non-invasive alternative to traditional methods. This approach enhances diagnostic precision and intervention success, suggesting broader implementation in routine cardiac care protocols in similar settings. Future studies should focus on multi-centre trials to expand these findings and improve cardiovascular outcomes across diverse populations.
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Dr Fahad Raja Khan
Cardiologist, Lady reading Hospital MTI Peshawar, Pakistan
Dr Shakeel Ahmed Memon
Assistant Professor of Cardiology, Lady reading Hospital MTI Peshawar, Pakistan
Dr Samra Rehmat
Assistant Professor and Consultant Interventional Cardiologist Lady reading Hospital MTI Peshawar, Pakistan
Dr Bahlool Khan
FCPS Resident Cardiology, Medical Officer, Lady reading Hospital MTI Peshawar, Pakistan