Incremental value of normal adenosine perfusion cardiac magnetic resonance

Long-term outcome

Fabiola B. Sozzi, Laura Iacuzio, Filippo Civaia, Ciro Canetta, Frederic Berthier, Stephane Rusek, Philippe Rossi, Federico Lombardi, Gilles Dreyfus, Vincent Dor

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background The purpose of the study was to determine the long-term prognostic value of normal adenosine stress cardiac magnetic resonance imaging (CMR) in patients referred for evaluation of myocardial ischemia. Methods We reviewed 300 consecutive patients (age 65 ± 11 years, 74% male) with suspected or known coronary disease and normal wall motion who had undergone adenosine stress CMR negative for ischemia and scar. Most patients were at intermediate risk of coronary artery disease. The end points studied were all causes of mortality and major adverse cardiac events, including cardiac death, myocardial infarction, revascularization, and hospitalization for unstable angina. Results During a mean follow-up of 5.5 years (mean = 5.4 ± 1.1), 16 patients died because of various causes (cardiac death in 5 patients). Three patients had a nonfatal myocardial infarction, 7 patients were hospitalized for revascularization, and 11 were medically treated for unstable angina. The annual cardiac event rate was 1.3% (0.78% in the first 3 years and 1.9% between the fourth and sixth years). The predictors of major adverse cardiac events in a multivariate analysis model were as follows: advanced age (hazard ratio [HR] 1.15, 95% confidence interval [95% CI] 1.02-1.30), diabetes (HR 17.5, 95% CI 2.2-140), and the habit of smoking (HR 5.9, 95% CI 1.0-35.5). For all causes of mortality, the only predictor was diabetes (HR 11.4, 95% CI 1.76-74.2). Patients with normal stress CMR had an excellent outcome during the 3 years after the study. The cardiac event rate was higher between the fourth and sixth years. Conclusion Over a 5.5-year period, a low event rate and excellent prognosis occurred in patients with normal adenosine stress CMR. Low- to intermediate-risk patients with a normal CMR are at low risk for subsequent cardiac events.

Original languageEnglish
Pages (from-to)841-846
Number of pages6
JournalAmerican Heart Journal
Volume169
Issue number6
DOIs
Publication statusPublished - Jun 1 2015

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Adenosine
Reference Values
Magnetic Resonance Spectroscopy
Perfusion
Magnetic Resonance Imaging
Confidence Intervals
Unstable Angina
Myocardial Infarction
Myocardial Revascularization
Mortality
Habits
Cicatrix
Myocardial Ischemia
Coronary Disease
Coronary Artery Disease
Cause of Death
Hospitalization
Multivariate Analysis
Ischemia
Smoking

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Incremental value of normal adenosine perfusion cardiac magnetic resonance : Long-term outcome. / Sozzi, Fabiola B.; Iacuzio, Laura; Civaia, Filippo; Canetta, Ciro; Berthier, Frederic; Rusek, Stephane; Rossi, Philippe; Lombardi, Federico; Dreyfus, Gilles; Dor, Vincent.

In: American Heart Journal, Vol. 169, No. 6, 01.06.2015, p. 841-846.

Research output: Contribution to journalArticle

Sozzi, FB, Iacuzio, L, Civaia, F, Canetta, C, Berthier, F, Rusek, S, Rossi, P, Lombardi, F, Dreyfus, G & Dor, V 2015, 'Incremental value of normal adenosine perfusion cardiac magnetic resonance: Long-term outcome', American Heart Journal, vol. 169, no. 6, pp. 841-846. https://doi.org/10.1016/j.ahj.2015.03.001
Sozzi, Fabiola B. ; Iacuzio, Laura ; Civaia, Filippo ; Canetta, Ciro ; Berthier, Frederic ; Rusek, Stephane ; Rossi, Philippe ; Lombardi, Federico ; Dreyfus, Gilles ; Dor, Vincent. / Incremental value of normal adenosine perfusion cardiac magnetic resonance : Long-term outcome. In: American Heart Journal. 2015 ; Vol. 169, No. 6. pp. 841-846.
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abstract = "Background The purpose of the study was to determine the long-term prognostic value of normal adenosine stress cardiac magnetic resonance imaging (CMR) in patients referred for evaluation of myocardial ischemia. Methods We reviewed 300 consecutive patients (age 65 ± 11 years, 74{\%} male) with suspected or known coronary disease and normal wall motion who had undergone adenosine stress CMR negative for ischemia and scar. Most patients were at intermediate risk of coronary artery disease. The end points studied were all causes of mortality and major adverse cardiac events, including cardiac death, myocardial infarction, revascularization, and hospitalization for unstable angina. Results During a mean follow-up of 5.5 years (mean = 5.4 ± 1.1), 16 patients died because of various causes (cardiac death in 5 patients). Three patients had a nonfatal myocardial infarction, 7 patients were hospitalized for revascularization, and 11 were medically treated for unstable angina. The annual cardiac event rate was 1.3{\%} (0.78{\%} in the first 3 years and 1.9{\%} between the fourth and sixth years). The predictors of major adverse cardiac events in a multivariate analysis model were as follows: advanced age (hazard ratio [HR] 1.15, 95{\%} confidence interval [95{\%} CI] 1.02-1.30), diabetes (HR 17.5, 95{\%} CI 2.2-140), and the habit of smoking (HR 5.9, 95{\%} CI 1.0-35.5). For all causes of mortality, the only predictor was diabetes (HR 11.4, 95{\%} CI 1.76-74.2). Patients with normal stress CMR had an excellent outcome during the 3 years after the study. The cardiac event rate was higher between the fourth and sixth years. Conclusion Over a 5.5-year period, a low event rate and excellent prognosis occurred in patients with normal adenosine stress CMR. Low- to intermediate-risk patients with a normal CMR are at low risk for subsequent cardiac events.",
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AU - Sozzi, Fabiola B.

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AU - Civaia, Filippo

AU - Canetta, Ciro

AU - Berthier, Frederic

AU - Rusek, Stephane

AU - Rossi, Philippe

AU - Lombardi, Federico

AU - Dreyfus, Gilles

AU - Dor, Vincent

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N2 - Background The purpose of the study was to determine the long-term prognostic value of normal adenosine stress cardiac magnetic resonance imaging (CMR) in patients referred for evaluation of myocardial ischemia. Methods We reviewed 300 consecutive patients (age 65 ± 11 years, 74% male) with suspected or known coronary disease and normal wall motion who had undergone adenosine stress CMR negative for ischemia and scar. Most patients were at intermediate risk of coronary artery disease. The end points studied were all causes of mortality and major adverse cardiac events, including cardiac death, myocardial infarction, revascularization, and hospitalization for unstable angina. Results During a mean follow-up of 5.5 years (mean = 5.4 ± 1.1), 16 patients died because of various causes (cardiac death in 5 patients). Three patients had a nonfatal myocardial infarction, 7 patients were hospitalized for revascularization, and 11 were medically treated for unstable angina. The annual cardiac event rate was 1.3% (0.78% in the first 3 years and 1.9% between the fourth and sixth years). The predictors of major adverse cardiac events in a multivariate analysis model were as follows: advanced age (hazard ratio [HR] 1.15, 95% confidence interval [95% CI] 1.02-1.30), diabetes (HR 17.5, 95% CI 2.2-140), and the habit of smoking (HR 5.9, 95% CI 1.0-35.5). For all causes of mortality, the only predictor was diabetes (HR 11.4, 95% CI 1.76-74.2). Patients with normal stress CMR had an excellent outcome during the 3 years after the study. The cardiac event rate was higher between the fourth and sixth years. Conclusion Over a 5.5-year period, a low event rate and excellent prognosis occurred in patients with normal adenosine stress CMR. Low- to intermediate-risk patients with a normal CMR are at low risk for subsequent cardiac events.

AB - Background The purpose of the study was to determine the long-term prognostic value of normal adenosine stress cardiac magnetic resonance imaging (CMR) in patients referred for evaluation of myocardial ischemia. Methods We reviewed 300 consecutive patients (age 65 ± 11 years, 74% male) with suspected or known coronary disease and normal wall motion who had undergone adenosine stress CMR negative for ischemia and scar. Most patients were at intermediate risk of coronary artery disease. The end points studied were all causes of mortality and major adverse cardiac events, including cardiac death, myocardial infarction, revascularization, and hospitalization for unstable angina. Results During a mean follow-up of 5.5 years (mean = 5.4 ± 1.1), 16 patients died because of various causes (cardiac death in 5 patients). Three patients had a nonfatal myocardial infarction, 7 patients were hospitalized for revascularization, and 11 were medically treated for unstable angina. The annual cardiac event rate was 1.3% (0.78% in the first 3 years and 1.9% between the fourth and sixth years). The predictors of major adverse cardiac events in a multivariate analysis model were as follows: advanced age (hazard ratio [HR] 1.15, 95% confidence interval [95% CI] 1.02-1.30), diabetes (HR 17.5, 95% CI 2.2-140), and the habit of smoking (HR 5.9, 95% CI 1.0-35.5). For all causes of mortality, the only predictor was diabetes (HR 11.4, 95% CI 1.76-74.2). Patients with normal stress CMR had an excellent outcome during the 3 years after the study. The cardiac event rate was higher between the fourth and sixth years. Conclusion Over a 5.5-year period, a low event rate and excellent prognosis occurred in patients with normal adenosine stress CMR. Low- to intermediate-risk patients with a normal CMR are at low risk for subsequent cardiac events.

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