Stress cardiac MRI provides excellent prognostic risk stratification in coronary artery disease: a systematic review of the literature
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KeywordsCardiac Magnetic Resonance Dobutamine Cardiovascular Mortality Cardiac Magnetic Resonance Imaging Obstructive Coronary Artery Disease
While the diagnostic accuracy of stress cardiac magnetic resonance imaging (CMR) for detecting obstructive coronary artery disease (CAD) has been established, the prognostic value of stress CMR is less well described in the literature. Thus, we performed meta-analysis to study the role of stress CMR in assessing cardiovascular prognosis.
CENTRAL, mRCT, and PubMed were searched for eligible studies that provided greater than 6 months of prognostic data on patients that underwent stress CMR. The primary end-points evaluated were cardiovascular mortality, myocardial infarction, and the combined endpoint of cardiovascular mortality or myocardial infarction. Pooling was performed using a random-effect model with summary effect estimates (95% confidence intervals) and annualized event rates were assessed. Values presented as mean ± standard error of the mean.
A negative stress CMR study (vasodilator or dobutamine) is associated with very low risk of cardiovascular mortality or myocardial infarction. Thus, stress CMR has excellent prognostic characteristics comparable to stress echocardiography or stress nuclear imaging and may help guide risk stratification of patients presenting with known or suspected CAD.
AHA 10SDG2650038, NIH K23 HL112910-01
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