Abstract 704: Long Term Prognostic Value of Stress Perfusion CMR Study for the Prediction of Cardiovascular Death and Non Fatal Acute Myocardial Infarction in 1009 Asian Patients
Background: Recent studies demonstrated the prognostic importance of stress perfusion MRI and late gadolinium enhanced (LGE) MRI in patients with suspected coronary artery disease (CAD). However, CAD rates and risk levels in Asian population have been shown to be lower than those in western countries. In the current study, we determined the long term (up to 10 years) prognostic value of CMR study with vasodilator stress in a large number of Asian patients.
Methods: We studied 1009 patients with known or suspected CAD who underwent both stress perfusion MRI and late gadolinium enhanced (LGE) MRI. Stress-induced ischemia and myocardial scar were qualitatively determined on CMR. Major adverse cardiac event (MACE) was defined as cardiovascular death and non fatal acute myocardial infarction (MI).
Results: During average follow-up time of 40 months (range, 6 to 120 months), presence of LGE predicted patients outcome with hazard ratio of 2.0 (95% CI 1.2–3.5, P<0.01). When stress perfusion MRI and LGE MRI were combined, abnormal stress CMR was a significant negative prognostic factor of MACE with a high hazard ratio of 5.2 (95% CI 2.2–12.0, P<0.001). Normal stress CMR was associated with lower event rate per year (0.3%) as compared with that by normal LGE alone (1.3%). (Figure 1⇓)
Conclusions: Combined assessment of stress induced ischemia and myocardial scar with stress CMR provided improved prognostic value when compared with LGE MRI alone in Asian population with known or suspected CAD. Patients with normal stress CMR had lower risk of cardiovascular death and MACE.