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

TitlePrognostic value of perfusion cardiovascular magnetic resonance with adenosine triphosphate stress in stable coronary artery disease
Authors
KeywordsAdenosine triphosphate
Stress
Cardiovascular magnetic resonance
Prognosis
Coronary artery disease
Issue Date2021
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.jcmr-online.com
Citation
Journal of Cardiovascular Magnetic Resonance, 2021, v. 23, p. article no. 75 How to Cite?
AbstractBackground 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. Methods 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. Results Median follow-up was 3.3 years. Patients with no stress perfusion defect had a lower incidence of MACE (p < 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 < 0.001, hazard ratio [HR] = 3.63), lower left ventricular ejection fractino (LVEF) (p < 0.001, HR = 0.96) and infarct detected by late gadolinium enhancement (LGE) (p = 0.001, HR = 2.92). Conclusion 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.
Persistent Identifierhttp://hdl.handle.net/10722/300927
ISSN
2023 Impact Factor: 4.2
2023 SCImago Journal Rankings: 2.242
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorNg, MY-
dc.contributor.authorChin, CY-
dc.contributor.authorYap, PM-
dc.contributor.authorWan, EYF-
dc.contributor.authorHai, JJSH-
dc.contributor.authorCheung, S-
dc.contributor.authorTse, HF-
dc.contributor.authorBucciarelli-Ducci, C-
dc.contributor.authorPennell, DJ-
dc.contributor.authorYiu, KH-
dc.date.accessioned2021-07-06T03:12:10Z-
dc.date.available2021-07-06T03:12:10Z-
dc.date.issued2021-
dc.identifier.citationJournal of Cardiovascular Magnetic Resonance, 2021, v. 23, p. article no. 75-
dc.identifier.issn1097-6647-
dc.identifier.urihttp://hdl.handle.net/10722/300927-
dc.description.abstractBackground 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. Methods 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. Results Median follow-up was 3.3 years. Patients with no stress perfusion defect had a lower incidence of MACE (p < 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 < 0.001, hazard ratio [HR] = 3.63), lower left ventricular ejection fractino (LVEF) (p < 0.001, HR = 0.96) and infarct detected by late gadolinium enhancement (LGE) (p = 0.001, HR = 2.92). Conclusion 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.-
dc.languageeng-
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.jcmr-online.com-
dc.relation.ispartofJournal of Cardiovascular Magnetic Resonance-
dc.rightsJournal of Cardiovascular Magnetic Resonance. Copyright © BioMed Central Ltd.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectAdenosine triphosphate-
dc.subjectStress-
dc.subjectCardiovascular magnetic resonance-
dc.subjectPrognosis-
dc.subjectCoronary artery disease-
dc.titlePrognostic value of perfusion cardiovascular magnetic resonance with adenosine triphosphate stress in stable coronary artery disease-
dc.typeArticle-
dc.identifier.emailNg, MY: myng2@hku.hk-
dc.identifier.emailWan, EYF: yfwan@hku.hk-
dc.identifier.emailHai, JJSH: haishjj@hku.hk-
dc.identifier.emailTse, HF: hftse@hkucc.hku.hk-
dc.identifier.emailYiu, KH: khkyiu@hku.hk-
dc.identifier.authorityNg, MY=rp01976-
dc.identifier.authorityWan, EYF=rp02518-
dc.identifier.authorityHai, JJSH=rp02047-
dc.identifier.authorityTse, HF=rp00428-
dc.identifier.authorityYiu, KH=rp01490-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/s12968-021-00770-z-
dc.identifier.pmid34162392-
dc.identifier.pmcidPMC8223349-
dc.identifier.scopuseid_2-s2.0-85108845689-
dc.identifier.hkuros323292-
dc.identifier.volume23-
dc.identifier.spagearticle no. 75-
dc.identifier.epagearticle no. 75-
dc.identifier.isiWOS:000668569200001-
dc.publisher.placeUnited Kingdom-

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