Abstract 372: Long-term Prognostic Value of Dobutamine Stress Cardiovascular Magnetic Resonance in 1466 Patients With Known or Suspected Coronary Artery Disease: A Single-center Experience
BACKGROUND: Aim of this study was to assess the long-term value of dobutamine stress cardiovascular magnetic resonance (DCMR) for prediction of late cardiac events in a large cohort of patients with known or suspected coronary artery disease.
METHODS: Clinical data and DCMR results were analyzed in 1466 consecutive patients undergoing DCMR between 2000 and 2006. Three hundred fifty five patients who underwent revascularization within 3 months of DCMR and 94 patients lost to follow-up were excluded; the remaining 1017 patients (median age, 62 years) were followed up for a mean of 38±18 months (range: 1 to 83 months). Wall motion abnormalities (WMA) at rest and the presence of stress-induced WMA (ischemia) were assessed for each patient. Cardiac events (cardiac death and non-fatal myocardial infarction) were related to clinical and DCMR results.
RESULTS: Twenty nine percent (n=295) of the patients experienced an inducible WMA during testing. Forty six cardiac events were reported, documented cardiac death in 33 (total death, 56) and non-fatal myocardial infarction in 13 patients. In those with and without inducible WMA, the proportion of patients with cardiac events were 8.0% versus 3.1%, respectively, (hazard ratio: 3.3; 95% confidence interval: 1.8 to 5.9 for the presence of inducible WMA; p<0.001). A normal DCMR carried a relatively good prognosis, with a 5-year event-free survival of 97.1%.
CONCLUSION: In a large cohort of patients, DCMR has an added value for predicting late cardiac events during long-term follow-up, improving the differentiation between high-risk and low-risk patients.