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 journalArticle

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

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Gadolinium
Magnetic resonance
Coronary Artery Disease
Magnetic Resonance Spectroscopy
Perfusion
Mortality
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Echocardiography
Electrocardiography
Angiotensin-Converting Enzyme Inhibitors
Aspirin
Observational Studies
Atherosclerosis
Hazards
Prospective Studies
Therapeutics
Population

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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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 journalArticle

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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.",
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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

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DO - 10.1155/2018/2806148

M3 - Article

C2 - 30035118

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SP - 2806148

JO - BioMed Research International

JF - BioMed Research International

SN - 2314-6133

ER -