Cardiac Magnetic Resonance Imaging Versus Invasive-Based Strategies in Patients With Chest Pain and Detectable to Mildly Elevated Serum Troponin: A Randomized Clinical Trial
An erratum to this article was published (Circ Cardiovasc Imaging, Jan 2024 ↗)
Primary resultResult — go to the resultHazard ratio 1.17 95% CI 0.86–1.57Authors' conclusion
Initial management with CMR or invasive-based care pathways resulted in no detectable difference in clinical and safety event rates.
Study context
- Population
- Patients with acute chest pain and contemporary troponin between detectable and 1.0 ng/mLconvenience sample
- Participants
- 312 patients
- Comparison
- Cardiac magnetic resonance (CMR)-based vs invasive-based care pathway
- CMR-basedn = 156
- Invasive-basedn = 156reference
- Primary endpoint
- Composite of:
- Death
- MI
- Cardiac-related hospital readmission or ED visits
- Follow-up
- Median 2.6 years
Methodological details4 US tertiary care hospitals, Early assigned testing initiated in 102 of 156 (65.3%) CMR-based and 110 of 156 (70.5%) invasive-based
- 4 US tertiary care hospitals
- Early assigned testing initiated in 102 of 156 (65.3%) CMR-based and 110 of 156 (70.5%) invasive-based
Primary result
As reported in the abstract
Hazard ratio
1.17
95% CI 0.86–1.57
By group
CMR-basedvs Invasive-based
HR 1.17 (95% CI 0.86–1.57)
Further findings
| Outcome | CMR-based | Invasive-based | HR (95% CI) | |
|---|---|---|---|---|
| ACS after discharge | 23% | 22% | 1.07 (0.67–1.71) | |
| Invasive angiography at any time | 52% | 74% | 0.66 (0.49–0.87) | |
| 0.512Hazard ratio (log scale) |
Therapeutic yield of angiography (interventions per angiography)
P = 0.001
| Outcome | CMR-based | Invasive-based |
|---|---|---|
| Safe discharge after negative CMR (no angiography or revascularization within 90 days), among those completing CMR | 58% | — not stated in the abstract |
— not stated in the abstract
- Safe discharge after negative CMR (no angiography or revascularization within 90 days), among those completing CMR: 55 out of 95 completing CMR
- Therapeutic yield of angiography (interventions per angiography): 52 in 81 vs 46 in 115 angiographies
Original publication
Cardiac Magnetic Resonance Imaging Versus Invasive-Based Strategies in Patients With Chest Pain and Detectable to Mildly Elevated Serum Troponin: A Randomized Clinical Trial. Circ Cardiovasc Imaging. Published 20 June 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →