Prognostic value of CMR in suspected CHD: 3 year follow-up of the CE-MARC study
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KeywordsAcute Coronary Syndrome Cardiovascular Magnetic Resonance Clinical Risk Factor Major Adverse Cardiovascular Event Prognostic Data
There are limited prospective, prognostic data for cardiovascular magnetic resonance (CMR) in the same patients with suspected coronary heart disease (CHD). CE-MARC established the diagnostic performance of CMR (and SPECT), with a predefined objective to determine both modalities' ability to predict major adverse cardiovascular events (MACE).
All CE-MARC patients underwent annual follow-up for 3 years to assess the occurrence of MACE (cardiovascular death, acute coronary syndrome, unscheduled revascularization or hospital admission for any cardiovascular cause). Time to MACE was assessed by univariate (log-rank test) and multivariate (Cox proportional hazards regression) analysis after adjustment for major cardiovascular risk factors. Net reclassification improvement (NRI) and discrimination (IDI) of the risk of MACE with CMR, incremental to standard clinical risk factors was calculated.
Three-year follow-up of the CE-MARC trial population demonstrates that abnormal CMR findings are independent predictors of MACE, and can reclassify patient risk beyond the standard major cardiovascular risk factors. This further supports the role of CMR for the assessment and management of patients with suspected CHD.
British Heart Foundation (RG/05/004).
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