Prognostic value of normal adenosine-stress cardiac magnetic resonance imaging
| Autor: | Guenter Pilz, Eman Ali, Markus Klos, Peter Bernhardt, Andrea Jeske, Berthold Hoefling, Roland Scheck |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Adenosine Time Factors medicine.medical_treatment Vasodilator Agents Coronary Artery Disease Revascularization Coronary Angiography Angina Coronary artery disease Diagnosis Differential Cardiac magnetic resonance imaging Internal medicine Germany medicine Humans cardiovascular diseases Myocardial infarction Prospective Studies Infusions Intravenous medicine.diagnostic_test business.industry Reproducibility of Results Canadian Cardiovascular Society Middle Aged medicine.disease Prognosis Magnetic Resonance Imaging Survival Rate Bypass surgery cardiovascular system Cardiology Exercise Test Female Radiology Cardiology and Cardiovascular Medicine business Mace Follow-Up Studies |
| Zdroj: | The American journal of cardiology. 101(10) |
| ISSN: | 0002-9149 |
| Popis: | We investigated the prognostic value of normal adenosine stress cardiac magnetic resonance (CMR) in suspected coronary artery disease (CAD). Prospectively enrolled in the study were 218 patients with suspected CAD, no stress hypoperfusion, and no delayed enhancement in CMR, and consecutively deferred coronary angiography. The primary end point was a 12-month rate of major adverse cardiac events (MACE; cardiovascular mortality, myocardial infarction, revascularization, hospitalization due to cardiovascular event). CMR indication was symptomatic angina (Canadian Cardiovascular Society II in 42% and III in 7%) or evaluation of myocardial ischemia in patients with arrhythmia, syncope, and/or equivocal stress tests and cardiovascular risk factors (51%). As the main result, the 12-month MACE rate was 2/218 (1 stent implantation, 1 bypass surgery) and CMR negative predictive value 99.1%. There was no cardiac death or myocardial infarction. In conclusion, normal adenosine stress CMR predicts a very low MACE rate and an excellent 1-year prognosis in patients with suspected CAD. Our results provide clinical reassurance that patients at risk for CAD-associated MACE were not missed by CMR. Hence, CMR may serve as a reliable noninvasive gatekeeper to reduce the number of redundant coronary angiographies. |
| Databáze: | OpenAIRE |
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