Comparison of Stress-Rest and Stress-LGE Analysis Strategy in Patients Undergoing Stress Perfusion Cardiovascular Magnetic Resonance
Authors' conclusion
In this analysis of CE-MARC, the optimum definition of inducible ischemia was the presence of a stress-induced perfusion defect without transmural infarction. This definition improved the diagnostic accuracy compared with the stress-rest analysis validated in the original study. The absence of ischemia by either analysis strategy conferred a favorable long-term prognosis.
Study context
- Population
- Patients from CE-MARC with complete stress perfusion, rest perfusion, late gadolinium enhancement (LGE) and quantitative coronary angiography data
- Participants
- 666 patients
- Comparison
- Stress-LGE vs stress-rest analysis of stress perfusion CMR
- Primary endpoint
- Diagnostic accuracy vs quantitative coronary angiography
Primary result
As reported in the abstract
| Group | AUC | Sensitivity | Specificity |
|---|---|---|---|
| Stress-LGE | 0.843 | 75.6% | 93.1% |
| Stress-rest | 0.834 | 73.6% | 93.1% |
AUC
Stress-LGE0.843
Stress-rest0.834
Sensitivity
Stress-LGE75.6%
Stress-rest73.6%
Specificity
Stress-LGE93.1%
Stress-rest93.1%
- Stress-LGE vs Stress-rest: P for difference = 0.02 — superior diagnostic accuracy of stress-LGE
Further findings
| Outcome | HR | P value |
|---|---|---|
| MACE, by presence of inducible ischemia (stress-LGE or stress-rest analysis) · median 6.5 yearsFor both analyses | 2.65 | P < 0.001 |
MACE, by presence of inducible ischemia (stress-LGE or stress-rest analysis) · median 6.5 years
- Presence of inducible ischemia similar and strongly predictive by either analysis
Original publication
Comparison of Stress-Rest and Stress-LGE Analysis Strategy in Patients Undergoing Stress Perfusion Cardiovascular Magnetic Resonance. Circ Cardiovasc Imaging. Published 6 December 2023. doi:10.
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