Cohort study
Comprehensive Phenotypic Characterization of Late Gadolinium Enhancement Predicts Sudden Cardiac Death in Coronary Artery Disease
- Prospective cohort study
- Cardiac magnetic resonance (CMR) registry
Authors' conclusion
Comprehensive LGE characterization independently predicted SCD risk beyond conventional predictors used in implantable cardioverter-defibrillator (ICD) insertion guidelines.
Study context
- Population
- Patients with stable coronary artery disease (CAD)
- Participants
- 437 patients
- Outcome
- Sudden cardiac death (SCD) or aborted SCD
Main finding
As reported in the abstract
median 6.3 years
Patients with primary outcome
49 (11.2%)
Peri-infarct zone (PIZ) mass, per gram (multivariable HR)
1.07 (95% CI 1.02-1.12); P = 0.002
Core infarct mass, per gram (multivariable HR)
1.03 (95% CI 1.01-1.05); P = 0.01
Discrimination with both parameters added (Harrell's C-statistic)
0.64-0.79
Observational data: associations, not effects.
Further findings
Scar microstructure features
- Number of late gadolinium enhancement (LGE) islands, scar transmurality, radiality, interface area and entropy associated with primary outcome after adjustment for severely reduced LVEF and NYHA class >1
- No microstructure feature remained associated after adding PIZ mass and core infarct mass
Original publication
Comprehensive Phenotypic Characterization of Late Gadolinium Enhancement Predicts Sudden Cardiac Death in Coronary Artery Disease. JACC Cardiovasc Imaging. Published 11 January 2023. doi:10.1016/j.jcmg.2022.10.020
Summarised from the published abstract; every number is checked against it