Feasibility and Prognostic Value of Stress Cardiovascular Magnetic Resonance in Patients With End-Stage Renal Disease
Authors' conclusion
In ESRD patients, stress CMR is feasible, safe, and adds significant prognostic value for MACE beyond traditional risk factors by characterizing patterns of microvascular and macrovascular disease.
Study context
- Population
- Asymptomatic patients with end-stage renal disease (ESRD) (estimated glomerular filtration rate <30 mL/min/1.73 m² or on dialysis) on waitlist for kidney transplantation, referred for stress cardiovascular magnetic resonance (CMR)included of 3328 ESRD patients, age 60 years [53–66], 67% men, median follow-up 5.4 years
- Participants
- 845 patients
- Exposure
- Stress CMR findings and major adverse cardiovascular events (MACE)
Main finding
As reported in the abstract
Major CMR-related adverse events
- No major CMR-related adverse events occurred
Observational data: associations, not effects.
Further findings
MACE by abnormal perfusion and late gadolinium enhancement · median follow-up of 5.4 years
| Comparison | aHR (95% CI) | P value | |
|---|---|---|---|
| Abnormal perfusion | 4.76 (3.34–6.79) | P < 0.001 | |
| Presence of late gadolinium enhancement | 3.86 (2.59–5.74) | P < 0.001 | |
| 0.10.31310Adjusted hazard ratio (log scale) |
MACE by typical and atypical ischemic heart disease patterns
| Comparison | aHR (95% CI) | P value | |
|---|---|---|---|
| Typical ischemic heart disease pattern | 5.68 (3.39–9.52) | P < 0.001 | |
| Atypical ischemic heart disease pattern | 5.84 (3.82–8.91) | P < 0.001 | |
| 0.10.31310Adjusted hazard ratio (log scale) |
- MACE by abnormal perfusion and late gadolinium enhancement: abnormal perfusion (12%); independent of traditional risk factors including prior coronary disease
- MACE by abnormal perfusion and late gadolinium enhancement: late gadolinium enhancement (22%); independent of traditional risk factors including prior coronary disease
Prognostic accuracy beyond American Heart Association 2012 risk criteria for ESRD patients
- C-statistic improvement
- 0.10
Original publication
Feasibility and Prognostic Value of Stress Cardiovascular Magnetic Resonance in Patients With End-Stage Renal Disease. JACC Adv. Published 28 July 2025. doi:10.
Summarised from the published abstract; every number is checked against it