Recipient organisationNIHR Leicester Biomedical Research Centre
NIHR supportRecorded as supported by this research centre
PeriodFeb 2025 — Mar 2039
In plain English
AI plain-English summary
Every year, at least 60,000 people in the UK are told they have heart failure, and most are then sent for an invasive angiogram—a test that threads a tube into the heart’s arteries via the groin or wrist, carrying a small risk of stroke and long waiting lists. This matters because coronary artery disease is the most common cause of heart failure, but the standard diagnostic test is expensive, exposes patients to radiation, and many patients would prefer to avoid it. The trial will randomly assign 3,000 newly diagnosed patients to one of three tests: the standard invasive angiogram, a CT coronary angiogram, or a stress cardiovascular MRI. Both alternatives are non-invasive and cheaper than current practice, but their accuracy in heart failure patients is not yet proven. If the trial shows that CT or MRI can reliably replace invasive angiography, the NHS could cut waiting lists, reduce procedure-related complications, and lower costs—without compromising diagnosis. The change would be invisible to most people but would quietly reshape how thousands of heart failure patients are assessed each year, shifting care from a hospital procedure to a scan.
View original technical description
Each year in the UK at least 60,000 patients are diagnosed with heart failure. Coronary artery disease (narrowing of the blood vessels supplying the heart) is the most common cause of heart failure. Invasive coronary angiography is often done as the first line test to identify coronary artery. However, we know from work with our patient and public involvement groups that most patients would prefer to avoid invasive coronary angiography if possible. The aim of this trial is to establish if it is possible to reduce the need for invasive angiography in patients with newly diagnosed heart failure. 3000 patients presenting with a new diagnosis of heart failure and not known to have coronary artery disease will be recruited. They will be randomly assigned (equal chance) to one of three tests: 1. Invasive coronary angiogram (current NHS practice)- A specialised X-ray test where dye is injected directly into the heart arteries via the groin or wrist. It carries a small risk of serious complications such as stroke. The test exposes patients to radiation and is expensive. Furthermore, there are long waiting lists for the test following many cancellations due to the COVID-19 pandemic. 2. CT coronary angiography - this test is quick, non-invasive and cheaper than invasive angiography. It has a high accuracy for detection of coronary artery disease but can be challenging in certain patient groups such as elderly patients or those with irregular heart rhythms. It also exposes patients to a small dose of ionising radiation. 3. Stress cardiovascular MRI - This test is non-invasive and cheaper than invasive angiography and provides additional information on the structure and function of the heart. The accuracy of this test for detection of coronary artery disease is unproven in patients with heart failure. It does not expose patients to ionising radiation.
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