Prognostic Value of Coronary Magnetic Resonance Angiography for Prediction of Cardiac Events in Patients With Suspected Coronary Artery Disease

被引：40

作者：

Yoon, Yeonyee E. ^{[1
,2
]}

Kitagawa, Kakuya ^{[1
]}

Kato, Shingo ^{[1
]}

Ishida, Masaki ^{[1
]}

Nakajima, Hiroshi ^{[3
]}

Kurita, Tairo ^{[4
]}

Ito, Masaaki ^{[3
]}

Sakuma, Hajime ^{[1
]}

机构：

[1] Mie Univ Hosp, Dept Radiol, Tsu, Mie 5148507, Japan

[2] Seoul Natl Univ, Div Cardiol, Cardiovasc Ctr, Bundang Hosp, Songnam, South Korea

[3] Mie Univ Hosp, Dept Cardiol, Tsu, Mie 5148507, Japan

[4] Matsusaka Cent Hosp, Dept Cardiol, Matsusaka, Mie, Japan

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2012年 / 60卷 / 22期

关键词：

coronary artery disease; magnetic resonance angiography; morbidity; prognosis; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; INTERNATIONAL MULTICENTER REGISTRY; MR-ANGIOGRAPHY; DIAGNOSTIC PERFORMANCE; CLINICAL-OUTCOMES; CT; ACCURACY; STENOSIS; STATE;

D O I：

10.1016/j.jacc.2012.07.060

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives This study sought to determine whether whole-heart coronary magnetic resonance angiography (CMRA) can predict cardiac events in patients with suspected coronary artery disease. Background Recent studies demonstrated that the presence of stenosis on coronary computed tomography angiography has a significant prognostic impact on the prediction of cardiac events. However, the prognostic value of whole-heart CMRA is unknown. Methods We studied 207 patients with suspected coronary artery disease who underwent non-contrast-enhanced free-breathing whole-heart CMRA acquired with a 1.5-T MR system and 32-channel cardiac coils. The presence of significant coronary stenosis (>= 50% diameter reduction) was visually determined on sliding thin-maximum intensity projection images. Follow-up information was obtained for occurrence of severe cardiac events (cardiac death, myocardial infarction, and unstable angina) and all cardiac events (additionally including revascularization > 90 days after CMRA). Results During a median follow-up of 25 months, 10 cardiac events, of which 5 were severe, were observed in 84 patients with significant stenosis. Whereas, in 123 patients without significant stenosis, only 1 cardiac event with no severe event was observed. Kaplan-Meier curves demonstrated a significant difference in event-free survival between the 2 groups for severe events (annual event rate, 3.9% and 0%, respectively; log-rank test, p = 0.003), as well as for all cardiac events (6.3% and 0.3%; p < 0.001). Cox regression analysis showed that presence of significant stenosis on CMRA was associated with a > 20-fold hazard increase for all cardiac events (hazard ratio: 20.78; 95% confidence interval: 2.65 to 162.70; p = 0.001). Conclusions Whole-heart CMRA is useful for predicting the future risk for cardiac events in patients with suspected coronary artery disease. (J Am Coll Cardiol 2012;60:2316-22) (C) 2012 by the American College of Cardiology Foundation

引用

页码：2316 / 2322

页数：7

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