Incremental value of normal adenosine perfusion cardiac magnetic resonance: Long-term outcome
| Autor: | Federico Lombardi, Frederic Berthier, Laura Iacuzio, Gilles Dreyfus, Stephane Rusek, Philippe Rossi, Filippo Civaia, Vincent Dor, Fabiola B. Sozzi, Ciro Canetta |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Adenosine medicine.medical_treatment Myocardial Ischemia Ischemia Coronary Disease Revascularization Risk Assessment Coronary artery disease Cardiac magnetic resonance imaging Cause of Death Internal medicine medicine Humans Myocardial infarction Aged medicine.diagnostic_test business.industry Unstable angina Hazard ratio Middle Aged medicine.disease Confidence interval Cardiology Female Cardiology and Cardiovascular Medicine business Magnetic Resonance Angiography Follow-Up Studies |
| Zdroj: | American Heart Journal. 169:841-846 |
| ISSN: | 0002-8703 |
| DOI: | 10.1016/j.ahj.2015.03.001 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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