Portal de investigación
Exercise ECG Testing and Stress Cardiac Magnetic Resonance for Risk Prediction in Patients With Chronic Coronary Syndrome.
Autores de INCLIVA
Participantes ajenos a INCLIVA
- Perez, Nerea
- Lopez-Lereu, Maria Pilar
- Monmeneu, Jose Vicente
Grupos y Plataformas de I+D+i
Abstract
PURPOSE: Vasodilator stress cardiac magnetic resonance (VS-CMR) has become crucial in the workup of patients with known or suspected chronic coronary syndrome (CCS). Whether traditional exercise ECG testing (ExECG) contributes prognostic information beyond VS-CMR is unclear. METHODS: We retrospectively included 288 patients with known or suspected CCS who had undergone ExECG and subsequent VS-CMR in our institution. Clinical, ExECG, and VS-CMR variables were recorded. We defined the serious adverse events (SAE) as a combined endpoint of acute coronary syndrome, admission for heart failure, or all-cause death. RESULTS: During a mean follow-up of 4.2 ± 2.15 yr, we registered 27 SAE (15 admissions for acute coronary syndrome, eight admissions for heart failure, and four all-cause deaths). Once adjusted for clinical, ExECG, and VS-CMR parameters associated with SAE, the only independent predictors were HRmax in ExECG (HR = 0.98: 95% CI, 0.96-0.99; P = .01) and more extensive stress-induced perfusion defects (PDs, number of segments) in VS-CMR (HR = 1.19: 95% CI, 1.07-1.34; P < .01). Adding HRmax significantly improved the predictive power of the multivariable model for SAE, including PDs (continuous reclassification improvement index: 0.47: 95% CI, 0.10-0.81; P < .05). The annualized SAE rate was 1% (if PD < 2 segments and HRmax > 130 bpm), 2% (if PD < 2 segments and HRmax = 130 bpm), 3.2% (if PD = 2 segments and HRmax > 130 bpm), and 6.3% (if PD = 2 segments and HRmax = 130 bpm), P < .01, for the trend. In patients on ß-blocker therapy, however, only PDs in VS-CMR, but not HRmax, predicted SAE. CONCLUSIONS: We conclude that ExECG contributes significantly to prognostic information beyond VS-CMR in patients with known or suspected CCS.
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Datos de la publicación
- ISSN/ISSNe:
- 1932-7501, 1932-751X
- Tipo:
- Article
- Páginas:
- 7-12
- PubMed:
- 34561369
Journal of Cardiopulmonary Rehabilitation and Prevention LIPPINCOTT WILLIAMS & WILKINS
Citas Recibidas en Web of Science: 2
Documentos
- No hay documentos
Filiaciones
Keywords
- all-cause mortality; heart rate; perfusion defect; prognosis; stable coronary artery disease
Financiación
Proyectos y Estudios Clínicos
Resolution of microvascular obstruction after myocardial infarction. A multidisciplinary approach to assess the structural and clinical consequences and to evaluate new therapeutic options.
Investigador Principal: VICENT BODÍ PERIS
PI20/00637 . INSTITUTO SALUD CARLOS III . 2021
Cita
Exercise ECG Testing and Stress Cardiac Magnetic Resonance for Risk Prediction in Patients With Chronic Coronary Syndrome. Marcos V, Merenciano H, Gabaldon A, Nunez G, Lorenzo M, Gavara J, Perez N et al. Journal of Cardiopulmonary Rehabilitation and Prevention. 2022 enero 01. 42 (1):7-12. DOI:10.1097/HCR.0000000000000621. PMID:34561369.
