Published online Jun 26, 2014. doi: 10.4330/wjc.v6.i6.405
Revised: March 10, 2014
Accepted: April 17, 2014
Published online: June 26, 2014
Cardiovascular disease (CVD) is the leading cause of death in the western world and is becoming more important in the developing world. Recently, advances in monitoring, revascularisation and pharmacotherapy have resulted in a reduction in mortality. However, although mortality rates have declined, the burden of disease remains large resulting in high direct and indirect healthcare costs related to CVDs. In Australia, acute coronary syndrome (ACS) accounts for more than 300000 years of life lost due to premature death and a total cost exceeding eight billion dollars annually. It is also the main contributor towards the discrepancy in life expectancy between indigenous and non-indigenous Australians. The high prevalence of CVD along with its associated cost urgently requires a reliable but non-invasive and cost-effective imaging modality. The imaging modality of choice should be able to accelerate the diagnosis of ACS, aid in the risk stratification of de novo coronary artery disease and avail incremental information of prognostic value such as viability which cardiovascular magnetic resonance (CMR) allows. Despite its manifold benefits, there are limitations to its wider use in routine clinical assessment and more studies are required into assessing its cost-effectiveness. It is hoped that with greater development in the technology and imaging protocols, CMR could be made less cumbersome, its imaging protocols less lengthy, the technology more inexpensive and easily applied in routine clinical practice.
Core tip: This review focuses on cardiovascular magnetic resonance in achieving speedy diagnosis, risk stratification and prognostication in acute coronary syndrome. It discusses the modalities already available towards achieving this end and the incremental information availed by cardiac magnetic resonance. The paper also discusses new imaging techniques and their contribution towards the cardiac magnetic resonance imaging assessment of patients with acute coronary syndrome.