Gianluca Pontone MD, Presenter: Speakers Bureau, General Electric Company Consultant, General Electric Company Research Consultant, HeartFlow, Inc Speakers Bureau, HeartFlow, Inc Speakers Bureau, Medtronic, Inc Speakers Bureau, Bayer AG

Erika Bertella, Abstract Co-Author: Nothing to Disclose

Monica Loguercio, Abstract Co-Author: Nothing to Disclose

Andrea Baggiano, Abstract Co-Author: Nothing to Disclose

Saima Mushtaq, Abstract Co-Author: Nothing to Disclose

Giovanni Donato Aquaro, Abstract Co-Author: Nothing to Disclose

Sara Salerni, Abstract Co-Author: Nothing to Disclose

Carmen Rossi, Abstract Co-Author: Nothing to Disclose

Piergiorgio Masci, Abstract Co-Author: Nothing to Disclose

Daniele Andreini MD, Abstract Co-Author: Consultant, General Electric Company

Adenosine stress perfusion cardiac magnetic resonance (CMR) and dobutamine CMR are useful techniques for the diagnostic and prognostic stratification based on perfusion defect and wall motion abnormalities (WMA), respectively. Dipyridamole stress CMR (DipCMR) is able to provide information on both phases of ischemic cascade. The aim of this study is to determine the prognostic value of DipCMR in patients with known or suspected coronary artery disease (CAD).

793 patients (63.9±10.9 yo, 657 men) with known or suspected CAD performed DipCMR and were followed-up for a mean follow-up of 810±665 days. Based on DipCMR findings, the study population was classified in group 1 (no reversible ischemia), group 2 (stress perfusion defect alone) and group 3 (stress perfusion defect and WMA). The endpoints were "all cardiac events" (unstable angina, myocardial infarction, cardiac death and revascularization) and "hard cardiac events" (all cardiac events excluding revascularization).

During a median follow-up of 622 days (range 425 to 963 days), 162 all cardiac events and 56 hard cardiac events were observed: 26 unstable angina, 22 nonfatal myocardial infarction and 5 cardiac death. The incidence of all cardiac events in group 1, 2 and 3 was 9.9%, 33.3% and 69%, respectively with a significant higher rate in group 2 vs group 1 (p<0.0001) and group 3 vs group 1 and 2 (p<0.0001). The hard cardiac events were observed in 4.9%, 8.5% and 17.8% of patients of group 1, 2 and 3, respectively, with a significant higher rate in group 3 vs group 1 (p<0.0001) and vs group 2 (p<0.05) while no differences were found between group 2 and 1 (p: 0.10). Multivariate analysis showed both stress perfusion defect alone [HR: 1.05 (1.0-1.1), p<0.05] or with WMA [HR: 2.9 (2.3-3.6), p<0.0001] as independent predictors of all cardiac events. Only stress perfusion defect plus WMA was predictor of hard cardiac events [HR: 1.6 (1.0-2.5), p<0.05].

DipCMR seems to have an added value for predicting cardiac events improving the prognostic stratification by the differentiation between the stress perfusion defect alone and the combined perfusion defect and WMA.

Dipyridamole stress cardiac magnetic resonance has an added value for predicting cardiac events

Pontone, G, Bertella, E, Loguercio, M, Baggiano, A, Mushtaq, S, Aquaro, G, Salerni, S, Rossi, C, Masci, P, Andreini, D, Long-term Prognostic Value of Dipyridamole Stress Cardiovascular Magnetic Resonance in Patients with Known or Suspected Coronary Artery Disease.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14010476.html