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 language | English |
|---|---|
| Pages (from-to) | 2806148 |
| Journal | BioMed Research International |
| Volume | 2018 |
| DOIs | |
| Publication status | Published - 2018 |
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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
Cite this
Cardiac Magnetic Resonance in Stable Coronary Artery Disease : Added Prognostic Value to Conventional Risk Profiling. / Catalano, Oronzo; Moro, Guido; Mori, Alessia; Perotti, Mariarosa; Gualco, Alessandra; Frascaroli, Mauro; Pesarin, Clara; Napolitano, Carlo; Ntusi, Ntobeko A B; Priori, Silvia G.
In: BioMed Research International, Vol. 2018, 2018, p. 2806148.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cardiac Magnetic Resonance in Stable Coronary Artery Disease
T2 - Added Prognostic Value to Conventional Risk Profiling
AU - Catalano, Oronzo
AU - Moro, Guido
AU - Mori, Alessia
AU - Perotti, Mariarosa
AU - Gualco, Alessandra
AU - Frascaroli, Mauro
AU - Pesarin, Clara
AU - Napolitano, Carlo
AU - Ntusi, Ntobeko A B
AU - Priori, Silvia G
PY - 2018
Y1 - 2018
N2 - 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.
AB - 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.
KW - Aged
KW - Contrast Media
KW - Coronary Artery Disease/diagnostic imaging
KW - Female
KW - Humans
KW - Magnetic Resonance Imaging, Cine
KW - Magnetic Resonance Spectroscopy
KW - Male
KW - Middle Aged
KW - Predictive Value of Tests
KW - Prognosis
KW - Prospective Studies
U2 - 10.1155/2018/2806148
DO - 10.1155/2018/2806148
M3 - Article
C2 - 30035118
VL - 2018
SP - 2806148
JO - BioMed Research International
JF - BioMed Research International
SN - 2314-6133
ER -