Prognostic value of perfusion cardiovascular magnetic resonance with adenosine triphosphate stress in stable coronary artery disease

Adenosine triphosphate (ATP) has been predominantly used in the Asia-Pacific region for stress perfusion cardiovascular magnetic resonance (CMR). We evaluated the prognosis of patients stressed using ATP, for which there are no current data. We performed a retrospective longitudinal study from Janua...

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Published in:Journal of cardiovascular magnetic resonance 2021-06, Vol.23 (1), p.75-11, Article 75
Main Authors: Ng, Ming-Yen, Chin, Chi Yeung, Yap, Pui Min, Wan, Eric Yuk Fai, Hai, JoJo Siu Han, Cheung, Stephen, Tse, Hung Fat, Bucciarelli-Ducci, Chiara, Pennell, Dudley John, Yiu, Kai-Hang
Format: Article
Language:English
Subjects:
Adenosine Triphosphate
ATP
Cardiology
Cardiovascular disease
Cardiovascular magnetic resonance
Contrast Media
Coronary artery
Coronary artery bypass
Coronary artery disease
Coronary Artery Disease - diagnostic imaging
Coronary vessels
Death
Gadolinium
Heart
Heart attack
Humans
Longitudinal Studies
Magnetic resonance
Magnetic Resonance Imaging, Cine
Magnetic Resonance Spectroscopy
Mortality
Muscle proteins
Myocardial infarction
Patients
Perfusion
Predictive Value of Tests
Prognosis
Rank tests
Regression analysis
Resonance
Retrospective Studies
Risk Assessment
Risk Factors
Standard deviation
Stress
Vasodilator Agents
Ventricle
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container_title Journal of cardiovascular magnetic resonance
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creator Ng, Ming-Yen
Chin, Chi Yeung
Yap, Pui Min
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Tse, Hung Fat
Bucciarelli-Ducci, Chiara
Pennell, Dudley John
Yiu, Kai-Hang
description Adenosine triphosphate (ATP) has been predominantly used in the Asia-Pacific region for stress perfusion cardiovascular magnetic resonance (CMR). We evaluated the prognosis of patients stressed using ATP, for which there are no current data. We performed a retrospective longitudinal study from January 2016 to December 2020 and included 208 subjects with suspected obstructive coronary artery disease (CAD) who underwent ATP stress perfusion CMR. An inducible stress perfusion defect was defined as a subendocardial dark rim involving ≥ 1.5 segments that persisted for ≥ 6 beats during stress but not at rest. The primary outcome measure was a composite of major adverse cardiovascular events (MACE) including (1) cardiac death, (2) nonfatal myocardial infarction, (3) cardiac hospitalization, (4) late coronary revascularization. We compared outcomes in patients with and without perfusion defect using Kaplan-Meier and log rank tests. Significant predictors of MACE were identified using multivariable Cox regression analysis. Median follow-up was 3.3 years. Patients with no stress perfusion defect had a lower incidence of MACE (p 
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We evaluated the prognosis of patients stressed using ATP, for which there are no current data. We performed a retrospective longitudinal study from January 2016 to December 2020 and included 208 subjects with suspected obstructive coronary artery disease (CAD) who underwent ATP stress perfusion CMR. An inducible stress perfusion defect was defined as a subendocardial dark rim involving ≥ 1.5 segments that persisted for ≥ 6 beats during stress but not at rest. The primary outcome measure was a composite of major adverse cardiovascular events (MACE) including (1) cardiac death, (2) nonfatal myocardial infarction, (3) cardiac hospitalization, (4) late coronary revascularization. We compared outcomes in patients with and without perfusion defect using Kaplan-Meier and log rank tests. Significant predictors of MACE were identified using multivariable Cox regression analysis. Median follow-up was 3.3 years. Patients with no stress perfusion defect had a lower incidence of MACE (p &lt; 0.001), including lower cardiac hospitalization (p = 0.004), late coronary revascularization (p = 0.001) and cardiac death (p = 0.003). Significant independent predictors for MACE were stress induced perfusion defect (p &lt; 0.001, hazard ratio [HR] = 3.63), lower left ventricular ejection fractino (LVEF) (p &lt; 0.001, HR = 0.96) and infarct detected by late gadolinium enhancement (LGE) (p = 0.001, HR = 2.92). Perfusion defects on ATP stress are predictive of MACE which is driven primarily by cardiac hospitalization, late coronary revascularization and cardiac death. 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We evaluated the prognosis of patients stressed using ATP, for which there are no current data. We performed a retrospective longitudinal study from January 2016 to December 2020 and included 208 subjects with suspected obstructive coronary artery disease (CAD) who underwent ATP stress perfusion CMR. An inducible stress perfusion defect was defined as a subendocardial dark rim involving ≥ 1.5 segments that persisted for ≥ 6 beats during stress but not at rest. The primary outcome measure was a composite of major adverse cardiovascular events (MACE) including (1) cardiac death, (2) nonfatal myocardial infarction, (3) cardiac hospitalization, (4) late coronary revascularization. We compared outcomes in patients with and without perfusion defect using Kaplan-Meier and log rank tests. Significant predictors of MACE were identified using multivariable Cox regression analysis. Median follow-up was 3.3 years. Patients with no stress perfusion defect had a lower incidence of MACE (p &lt; 0.001), including lower cardiac hospitalization (p = 0.004), late coronary revascularization (p = 0.001) and cardiac death (p = 0.003). Significant independent predictors for MACE were stress induced perfusion defect (p &lt; 0.001, hazard ratio [HR] = 3.63), lower left ventricular ejection fractino (LVEF) (p &lt; 0.001, HR = 0.96) and infarct detected by late gadolinium enhancement (LGE) (p = 0.001, HR = 2.92). Perfusion defects on ATP stress are predictive of MACE which is driven primarily by cardiac hospitalization, late coronary revascularization and cardiac death. Significant independent predictors of MACE were stress induced perfusion defect, lower LVEF and infarct detected by LGE.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>34162392</pmid><doi>10.1186/s12968-021-00770-z</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-9533-3892</orcidid><oa>free_for_read</oa></addata></record>
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source ScienceDirect; Publicly Available Content Database; PubMed Central
subjects Adenosine Triphosphate
ATP
Cardiology
Cardiovascular disease
Cardiovascular magnetic resonance
Contrast Media
Coronary artery
Coronary artery bypass
Coronary artery disease
Coronary Artery Disease - diagnostic imaging
Coronary vessels
Death
Gadolinium
Heart
Heart attack
Humans
Longitudinal Studies
Magnetic resonance
Magnetic Resonance Imaging, Cine
Magnetic Resonance Spectroscopy
Mortality
Muscle proteins
Myocardial infarction
Patients
Perfusion
Predictive Value of Tests
Prognosis
Rank tests
Regression analysis
Resonance
Retrospective Studies
Risk Assessment
Risk Factors
Standard deviation
Stress
Vasodilator Agents
Ventricle
title Prognostic value of perfusion cardiovascular magnetic resonance with adenosine triphosphate stress in stable coronary artery disease
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