Portal de investigación
Combined assessment of stress cardiovascular magnetic resonance and angiography to predict the effect of revascularization in chronic coronary syndrome patients.
Fecha de publicación:
Fecha Ahead of Print:
Autores de INCLIVA
Participantes ajenos a INCLIVA
- Gavara, Jose
- Perez, Nerea
- Monmeneu, Jose V
- Lopez-Lereu, Maria P
- Moratal, David
Grupos y Plataformas de I+D+i
Abstract
AIMS: The role of revascularization in chronic coronary syndrome (CCS) and the value of ischaemia vs. anatomy to guide decision-making are in constant debate. We explored the potential of a combined assessment of ischaemic burden by vasodilator stress cardiovascular magnetic resonance (CMR) and presence of multivessel disease by angiography to predict the effect of revascularization on all-cause mortality in CCS. METHODS AND RESULTS: The study group comprised 1066 CCS patients submitted to vasodilator stress CMR pre-cardiac catheterization (mean age 66 ± 11 years, 69% male). Stress CMR-derived ischaemic burden (extensive if >5 ischaemic segments) and presence of multivessel disease in angiography (two- or three-vessel or left main stem disease) were computed. The influence of revascularization on all-cause mortality was explored and adjusted hazard ratios (HRs) with the corresponding 95% confidence intervals were obtained. During a median 7.51-year follow-up, 557 (52%) CMR-related revascularizations and 308 (29%) deaths were documented. Revascularization exerted a neutral effect on all-cause mortality in the whole study group [HR 0.94 (0.74-1.19), P = 0.6], in patients without multivessel disease [n = 598, 56%, HR 1.12 (0.77-1.62), P = 0.6], and in those with multivessel disease without extensive ischaemic burden [n = 181, 17%, HR 1.66 (0.91-3.04), P = 0.1]. However, compared to non-revascularized patients, revascularization significantly reduced all-cause mortality in patients with simultaneous multivessel disease and extensive ischaemic burden (n = 287, 27%): 3.77 vs. 7.37 deaths per 100 person-years, HR 0.60 (0.40-0.90), P = 0.01. CONCLUSIONS: In patients with CCS submitted to catheterization, evidence of simultaneous extensive CMR-related ischaemic burden and multivessel disease identifies the subset in whom revascularization can reduce all-cause mortality.
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.
Datos de la publicación
- ISSN/ISSNe:
- 2047-4873, 2047-4881
- Tipo:
- Article
- Páginas:
- 407-416
- PubMed:
- 34686874
European Journal of Preventive Cardiology SAGE PUBLICATIONS LTD
Citas Recibidas en Web of Science: 3
Documentos
Filiaciones
Keywords
- All-cause mortality; Cardiovascular magnetic resonance; Ischaemic burden; Ischaemic heart disease; Prognosis; Revascularization
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
Gavara J,Perez N,Marcos V,Monmeneu JV,Lopez MP,Rios C,de Dios E,Bonanad C,Canoves J,Moratal D,Palau P,Minana G,Nunez J,Chorro FJ,Bodi V. Combined assessment of stress cardiovascular magnetic resonance and angiography to predict the effect of revascularization in chronic coronary syndrome patients. Eur. J. Prev. Cardiol. 2022. 29. (2):p. 407-416. IF:8,300. (1).
Combined assessment of stress cardiovascular magnetic resonance and angiography to predict the effect of revascularization in chronic coronary syndrome patients. Gavara J, Perez N, Marcos V, Monmeneu JV, Lopez MP, Rios C, de Dios E et al. European Journal of Preventive Cardiology. 2022 marzo 11. 29 (2):407-416. DOI:10.1093/eurjpc/zwab170. PMID:34686874.
