Abstract 12130: Prognostic Value of Dobutamine Stress CMR in Patients with Coronary and Peripheral Arterial Disease
BACKGROUND: Patients with coronary and peripheral arterial disease are at high risk of cardiovascular events. Aim of this study was to assess the value of dobutamine stress cardiovascular magnetic resonance (DCMR) for prediction of cardiac events in patients with coronary and peripheral arterial disease.
METHODS: Clinical data and DCMR results were analyzed in 215 consecutive patients with coronary and peripheral arterial disease undergoing DCMR between 2000 and 2004. Follow up was successful for 205 (95.3%) patients. Sixty five patients who underwent early revascularisation (≤3 months) after the test were excluded from analysis. The remaining 140 patients (median age, 65 years) were followed up for a mean of 39 ± 18 months. Wall motion abnormalities (WMA) at rest and the presence of stress-induced WMA (ischemia) were assessed for each patient. Cox proportional hazards regression models were used to identify independent predictors of the composite of cardiac events defined as cardiac death and non-fatal myocardial infarction.
RESULTS: Fifty two patients (37.1%) experienced an inducible WMA during testing. Fifteen cardiac events were reported, cardiac death in 13 and non-fatal myocardial infarction in 2 patients. In multivariate analysis of clinical data, stress-induced WMA on DCMR (HR 5.8, 95% CI 1.6 to 21.3; p=0.008) was an independent predictor of late cardiac events (Figure). Patients without inducible WMA demonstrated a good prognosis, with a 48-months event-free survival of 95.5%.
CONCLUSION: Myocardial ischaemia during DCMR is an independent predictor of cardiac events in patients with coronary and peripheral arterial disease.
Figure: Kaplan-Meier survival curves of patients with coronary and peripheral arterial disease if patients are stratified according to DCMR result.
- © 2011 by American Heart Association, Inc.