- Cardiac magnetic resonance (CMR) imaging of patients with suspected myocardial ischemia but no coronary artery disease (CAD) history reclassifies risk for many patients.
Why this matters
- In these patients, stress CMR imaging may add prognostic value for myocardial infarction (MI) and cardiovascular death, in addition to supporting decision-making with adjusted risk stratification.
- Median follow-up, 5.4 (interquartile range, 4.6-6.9) years.
- 3.9% had cardiovascular death/nonfatal MI.
- 11.2% had a major adverse cardiac event (MACE).
- 13.4% of 1698 were positive for ischemia on stress CMR imaging.
- Adding imaging parameters to baseline risk models yielded better classification of these patients.
- Stress CMR imaging reclassified 33.5% (568 of 1698) into a more apt risk group for cardiovascular death/nonfatal MI, especially reclassification from intermediate risk (60.3%) to low (52.4%) or high risk (7.9%).
- Stress CMR imaging also reclassified 59.9% of patients from intermediate risk for MACE to higher (48.7%) or lower (11.2%) risk.
- Retrospective, multicenter cohort study at 13 US centers.
- Funding: Siemens Healthineers; Bayer AG.
- Some key data on wall motion abnormalities not available.