TY - JOUR
T1 - The prognostic value of normal stress cardiac magnetic resonance in patients with known or suspected coronary artery disease
T2 - A meta-analysis
AU - Gargiulo, Paola
AU - Dellegrottaglie, Santo
AU - Bruzzese, Dario
AU - Savarese, Gianluigi
AU - Scala, Oriana
AU - Ruggiero, Donatella
AU - D'Amore, Carmen
AU - Paolillo, Stefania
AU - Agostoni, Piergiuseppe
AU - Bossone, Edoardo
AU - Soricelli, Andrea
AU - Cuocolo, Alberto
AU - Trimarco, Bruno
AU - Filardi, Pasquale Perrone
PY - 2013/7
Y1 - 2013/7
N2 - Background-Ischemia detection with stress cardiac magnetic resonance (CMR) is typically based on induction of either myocardial perfusion defect or wall motion abnormality. Single-center studies have shown the high value of stress CMR for risk stratification. The aim of this study was to define the prognostic value of stress CMR for prediction of adverse cardiac events in patients with known or suspected coronary artery disease. Methods and Results-Studies published between January 1985 and April 2012 were identified by database search. We included studies using stress CMR to evaluate subjects with known or suspected coronary artery disease and providing primary data on clinical outcomes of nonfatal myocardial infarction or cardiac death with a follow-up time ≥3 months. Total of 14 studies were finally included, recruiting 12 178 patients. The negative predictive value for nonfatal myocardial infarction and cardiac death of normal CMR was 98.12% (95% confidence interval, 97.26-98.83) during a weighted mean follow-up of 25.3 months, resulting in estimated event rate after a negative test equal to 1.88% (95% confidence interval, 1.17-2.74). The corresponding annualized event rate after a negative test was 1.03%. Comparable negative predictive values for major coronary events were obtained in studies considering the absence of inducible perfusion defect compared with those evaluating the absence of inducible wall motion abnormality (98.39% versus 97.31%, respectively; P=0.227 by meta-regression analysis). Conclusions-Stress CMR has a high negative predictive value for adverse cardiac events, and the absence of inducible perfusion defect or wall motion abnormality shows a similar ability to identify low-risk patients with known or suspected coronary artery disease.
AB - Background-Ischemia detection with stress cardiac magnetic resonance (CMR) is typically based on induction of either myocardial perfusion defect or wall motion abnormality. Single-center studies have shown the high value of stress CMR for risk stratification. The aim of this study was to define the prognostic value of stress CMR for prediction of adverse cardiac events in patients with known or suspected coronary artery disease. Methods and Results-Studies published between January 1985 and April 2012 were identified by database search. We included studies using stress CMR to evaluate subjects with known or suspected coronary artery disease and providing primary data on clinical outcomes of nonfatal myocardial infarction or cardiac death with a follow-up time ≥3 months. Total of 14 studies were finally included, recruiting 12 178 patients. The negative predictive value for nonfatal myocardial infarction and cardiac death of normal CMR was 98.12% (95% confidence interval, 97.26-98.83) during a weighted mean follow-up of 25.3 months, resulting in estimated event rate after a negative test equal to 1.88% (95% confidence interval, 1.17-2.74). The corresponding annualized event rate after a negative test was 1.03%. Comparable negative predictive values for major coronary events were obtained in studies considering the absence of inducible perfusion defect compared with those evaluating the absence of inducible wall motion abnormality (98.39% versus 97.31%, respectively; P=0.227 by meta-regression analysis). Conclusions-Stress CMR has a high negative predictive value for adverse cardiac events, and the absence of inducible perfusion defect or wall motion abnormality shows a similar ability to identify low-risk patients with known or suspected coronary artery disease.
KW - Cardiac magnetic resonance imaging
KW - Chronic ischemic heart disease
KW - Coronary artery disease
KW - Prognostic value
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U2 - 10.1161/CIRCIMAGING.113.000035
DO - 10.1161/CIRCIMAGING.113.000035
M3 - Article
C2 - 23771988
AN - SCOPUS:84884473137
VL - 6
SP - 574
EP - 582
JO - Circulation: Cardiovascular Imaging
JF - Circulation: Cardiovascular Imaging
SN - 1941-9651
IS - 4
ER -