Cardiac Magnetic Resonance in Stable Coronary Artery Disease: Added Prognostic Value to Conventional Risk Profiling

Oronzo Catalano, Guido Moro, Alessia Mori, Mariarosa Perotti, Alessandra Gualco, Mauro Frascaroli, Clara Pesarin, Carlo Napolitano, Ntobeko A B Ntusi, Silvia G Priori

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: Cardiovascular magnetic resonance (CMR) permits a comprehensive evaluation of stable coronary artery disease (CAD). We sought to assess whether, in a large contemporaneous population receiving optimal medical therapy, CMR independently predicts prognosis beyond conventional cardiovascular risk factors (RF).

Methods: We performed a single centre, observational prospective study that enrolled 465 CAD patients (80% males; 63±11 years), optimally treated with ACE-inhibitors/ARB, aspirin, and statins (76-85%). Assessments included conventional evaluation (clinical history, atherosclerosis RF, electrocardiography, and echocardiography) and a comprehensive CMR with LV dimensions/function, late gadolinium enhancement (LGE), and stress perfusion CMR (SPCMR).

Results: During a median follow-up of 62 months (IQR 23-74) there were 50 deaths and 92 major adverse cardiovascular events (MACE). CMR variables improved multivariate model prediction power of mortality and MACE over traditional RF alone (F-test p<0.05 and p<0.001, respectively). LGE was an independent prognostic factor of mortality (hazard ratio [95% CI]: 3.4 [1.3-8.8]); moreover, LGE (3.3 [1.7-6.3]) and SPCMR (2.1 [1.4-3.2]) were the best predictors of MACE.

Conclusion: LGE is an independent noninvasive marker of mortality in the long term in patients with stable CAD and optimized medical therapy. Furthermore, LGE and SPCMR independently predict MACE beyond conventional risk stratification.

Original languageEnglish
Pages (from-to)2806148
JournalBioMed Research International
Volume2018
DOIs
Publication statusPublished - 2018

Keywords

  • Aged
  • Contrast Media
  • Coronary Artery Disease/diagnostic imaging
  • Female
  • Humans
  • Magnetic Resonance Imaging, Cine
  • Magnetic Resonance Spectroscopy
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies

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