Details

Autor(en) / Beteiligte

• Marcos-Garces, Victor
• Gavara, Jose
• Monmeneu, Jose V
• Lopez-Lereu, Maria P
• Bosch, Maria J
• Merlos, Pilar
• Perez, Nerea
• Rios-Navarro, Cesar
• De Dios, Elena
• Bonanad, Clara
• Racugno, Paolo
• Bellver Navarro, Alejandro
• Ventura Perez, Bruno
• Aguilar Botella, Jose
• Ventura, Silvia
• Mainar, Luis
• Canoves, Joaquim
• Pellicer, Mauricio
• Moratal, David
• Miñana, Gema
• Nuñez, Julio
• Chorro, Francisco J
• Bodi, Vicente

Titel

Vasodilator Stress CMR and All-Cause Mortality in Stable Ischemic Heart Disease: A Large Retrospective Registry

Ist Teil von

• JACC. Cardiovascular imaging, 2020-08, Vol.13 (8), p.1674-1686

Ort / Verlag

United States

Erscheinungsjahr

2020

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• This study explored the association of ischemic burden, as measured by vasodilator stress cardiovascular magnetic resonance (CMR), with all-cause mortality and the effect of revascularization on all-cause mortality in patients with stable ischemic heart disease (SIHD). In patients with SIHD, the association of ischemic burden, derived from vasodilator stress CMR, with all-cause mortality and its role for decision-making is unclear. The registry consisted of 6,389 consecutive patients (mean age: 65 ± 12 years; 38% women) who underwent vasodilator stress CMR for known or suspected SIHD. The ischemic burden (at stress first-pass perfusion imaging) was computed (17-segment model). The effect of CMR-related revascularization (within the following 3 months) on all-cause mortality was retrospectively explored using the electronic regional health system registry. During a 5.75-year median follow-up, 717 (11%) deaths were documented. In multivariable analyses, more extensive ischemic burden (per 1-segment increase) was independently related to all-cause mortality (hazard ratio: 1.04; 95% confidence interval: 1.02 to 1.07; p < 0.001). In 1,032 1:1 matched patients using a limited number of variables (516 revascularized, 516 non-revascularized), revascularization within the following 3 months was associated with less all-cause mortality only in patients with extensive CMR-related ischemia (>5 segments, n = 432; 10% vs. 24%; p = 0.01). In a large retrospective registry of unselected patients with known or suspected SIHD who underwent vasodilator stress CMR, extensive ischemic burden was related to a higher risk of long-term, all-cause mortality. Revascularization was associated with a protective effect only in the restricted subset of patients with extensive CMR-related ischemia. Further research will be needed to confirm this hypothesis-generating finding.