Heart failure & cardiomyopathiesRandomised controlled trial
Cardiac Magnetic Resonance Imaging vs Coronary Angiography as Primary Strategy in Newly Diagnosed Heart Failure
- Randomised diagnostic trial
- multicentre
- 2-armed
- blinded expert panels
Authors' conclusion
Although CATH was superior for diagnosing ICM, CMR showed similar sensitivity and could significantly reduce CATH procedures without increasing the risk of missing critical coronary interventions.
Study context
- Population
- Adults with new-onset heart failure with reduced ejection fraction (HFrEF)203 with evaluable pairs
- Participants
- 229 adults
- Comparison
- Cardiac magnetic resonance (CMR)-first vs CATH-first strategy
- CATHn = 108reference
- Primary endpoint
- Diagnosis of ischemic cardiomyopathy (ICM), CMR-first vs CATH
Primary result
As reported in the abstract
ICM diagnosis
| Group | Value | Sufficient for ischemic cardiomyopathy (ICM) diagnosis (panel) | Sensitivity | Specificity |
|---|---|---|---|---|
| CATH | 100% | 100% (105/105) | 91% | 98% |
| CMR | 80% | 80% (76/95) | 90% | 74% |
- CMR vs CATH: P < 0.001 — sufficient for ICM diagnosis
- CMR vs CATH: P = 1.00 — sensitivity
- CMR vs CATH: P < 0.001 — specificity
Secondary outcomes
| Outcome | CMR | CATH |
|---|---|---|
| CATH procedures avoidable with CMR-first strategy (CMR panel) | 48% | |
| Excluding patients with coronary interventions | 45% | Not reported in the abstract |
Original publication
Cardiac Magnetic Resonance Imaging vs Coronary Angiography as Primary Strategy in Newly Diagnosed Heart Failure. JACC Heart Fail. Published 12 July 2025. doi:10.1016/j.jchf.2025.102528
Summarised from the published abstract; every number is checked against it