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RESEARCH PRODUCT
Long-term prognostic implications of revascularization in patients with known or suspected chronic coronary syndromes without ischemia in vasodilator stress cardiovascular magnetic resonance
Vicent BodíJulio NúñezVíctor Marcos-garcésCesar Rios-navarroGema MiñanaJose Gavarasubject
medicine.medical_specialtyMagnetic Resonance SpectroscopyVasodilator Agentsmedicine.medical_treatmentMyocardial InfarctionIschemiaPerfusion scanningCoronary Artery Disease030204 cardiovascular system & hematologyRevascularization03 medical and health sciences0302 clinical medicinePredictive Value of TestsInternal medicinemedicineClinical endpointHumans030212 general & internal medicineMyocardial infarctionStrokeAgedRetrospective Studiesmedicine.diagnostic_testbusiness.industryMagnetic resonance imagingSyndromeMiddle AgedPrognosismedicine.diseaseMagnetic Resonance ImagingHeart failureCardiologyFemaleCardiology and Cardiovascular Medicinebusinessdescription
In this study, we evaluated the association between symptoms-guided revascularization occurred within three months following a negative vasodilator stress cardiovascular magnetic resonance (negative stress-CMR) and long-term adverse events in patients with known or suspected chronic coronary syndrome (CCS).We retrospectively evaluated 3517 patients in which the stress first-pass perfusion imaging revealed no ischemia. The primary endpoint was the composite of death, spontaneous myocardial infarction, heart failure (HF), or stroke. The association between symptoms-guided revascularization after a negative stress-CMR and the endpoint was assessed using the multivariable Cox proportional hazard regression model.The mean age was 64.7 ± 11.9 years and 45.4% were females. Coronary angiography and revascularization following a negative stress-CMR were performed in 176 (5%) and 59 (1.7%) patients. At a median follow-up of 4.8 years (2.0-8.2), 529 (15%) patients experienced the primary endpoint (2.0 per 100 person-years). Revascularization following a negative CMR was associated with a higher incidence of the composite (4.85 vs. 1.96 per 100 person-years, p0.001) and each of the isolated components of the endpoint, except for the HF endpoint, in which differences were borderline significant. After multivariate adjustment, revascularization remained associated with an excess of risk (HR = 2.01, 95% CI:1.21-3.30; p = 0.007).In CCS patients with persistent symptoms but without evidence of ischemia in vasodilator stress CMR, revascularization was associated with a higher risk of adverse clinical events.
year | journal | country | edition | language |
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2021-01-10 | International Journal of Cardiology |