Abstract 14954: The Role of Dobutamine Stress Magnetic Resonance Imaging in the Clinical Management of Patients with Coronary Artery Disease
Background: Recent studies have demonstrated the consistently high diagnostic and prognostic value of dobutamine stress magnetic resonance (DSMR) imaging. The value of DSMR for clinical decision making still needs to be defined. Hence, the purpose of this study was to assess the utility of DSMR regarding clinical management of patients with suspected and known coronary artery disease (CAD) in a routine setting.
Methods and Results: We prospectively performed a standard DSMR examination in 1532 consecutive patients with suspected and known CAD. Patients were stratified according to the results of DSMR: DSMR-positive patients were recommended to undergo invasive coronary angiography and DSMR-negative patients received optimal medical treatment. Of 609 (40%) DSMR-positive patients coronary angiography was performed in 478 (78%) within 90 days. In 409 of these patients significant coronary stenoses =50% were present (sensitivity 86%). Of 923 (60%) DSMR-negative patients 833 (90%) received optimal medical therapy. During a median follow-up period of 2.1 years (interquartile range 1.5 to 2.7 years) 8 DSMR-negative patients (0.96%) sustained a cardiac event. In 131 DSMR-positive patients who did not undergo invasive angiography, 20 patients (15%) suffered cardiac events. In 90 DSMR-negative patients (10%) invasive angiography was performed within 2 years (range 0.01 to 2.0 years) with 56 patients having coronary stenoses =50%.
Conclusion: DSMR can be used as an arbiter in a routine setting for clinical decision making and has high utility for clinical management of patients with suspected and known CAD.
- © 2010 by American Heart Association, Inc.