From Seed Funding to Global Impact: Heart Research shaping Patient Care
Approximately one in ten people who present to hospital with symptoms of a heart attack are found to have no blockage in their coronary arteries. This condition, known as myocardial infarction with non-obstructive coronary arteries (MINOCA), presents a significant diagnostic challenge for clinicians. Without a clear cause, doctors are often required to rely on clinical judgement alone, which can result in uncertainty around both diagnosis and treatment.
This uncertainty has real consequences for patients. Standard treatment following a heart attack often includes prolonged use of blood-thinning medication, which is critical when a blood clot is the cause but carries risks when prescribed unnecessarily. In many cases of MINOCA, the event is not caused by a blood clot at all, meaning patients may be exposed to powerful medications they do not need. Identifying when blood-thinning treatment can be safely stopped is therefore a critical patient safety issue.
Supported by the RPH Research Foundation through a Seed Funding Grant in 2018, this research has now been published internationally, highlighting how early investment in medical research can lead to meaningful improvements in patient care years later.
When this research was first funded, there was limited evidence to show whether cardiac magnetic resonance imaging (MRI) could genuinely influence real-world clinical decisions for patients with MINOCA. While cardiac MRI is able to produce highly detailed images of the heart muscle, it was not clear whether this additional information would change how patients were managed or justify the cost of the scan.
To address this evidence gap, researchers followed more than 300 patients diagnosed with MINOCA across multiple international centres. Doctors recorded their diagnosis, level of certainty and intended treatment before and after each patient underwent a cardiac MRI scan. The findings showed that access to cardiac MRI frequently led to changes in clinical thinking, with the scan altering the diagnosis, the treatment plan, or both in nearly two-thirds of patients. Doctors also reported significantly greater confidence in their decisions after reviewing the MRI results, particularly when scans were performed early and when there was uncertainty at the outset.
Crucially, cardiac MRI helped clinicians identify patients who did not need to remain on blood-thinning medication. The study showed that for every three patients scanned, one was able to safely stop unnecessary treatment, reducing the risk of medication-related complications and improving overall care.
The publication of this research demonstrates the long-term value of seed funding in enabling early-stage studies to mature into evidence that informs clinical practice. Years after the initial investment, the findings are now contributing to improved diagnosis, safer treatment decisions and more personalised care for patients with complex heart conditions. Through its Seed Funding Grants, the RPH Research Foundation continues to support research that bridges critical knowledge gaps and delivers real-world impact for patients in Western Australia and beyond.
