Heart failure & cardiomyopathies
Prevalence of Angiographic Coronary Artery Disease in Systolic Heart Failure Without Infarct-Pattern Late Gadolinium Enhancement: A Systematic Review and Meta-analysis
Authors' conclusion
Among selected adults with HFrEF or otherwise unexplained LVSD who underwent paired LGE-CMR and ICA, absence of infarct-pattern LGE did not exclude angiographic CAD. Further coronary assessment should be considered when resolving that uncertainty would alter diagnosis or management.
Study context
- Population
- Adults with heart failure and reduced ejection fraction (HFrEF) or otherwise unexplained left ventricular systolic dysfunction without infarct-pattern LGE, with paired late gadolinium enhancement cardiovascular magnetic resonance (LGE-CMR) and invasive coronary angiography (ICA)paired LGE-CMR and ICA, Twenty-two reports representing 20 studies
- Participants
- 2,236 adults
- Comparison
- Scar-negative vs Infarct-pattern scar
- Scar-negativen = 1,418
- Infarct-pattern scarn = 818
- Outcome
- Angiographic CAD, ≥50% stenosis, among scar-negative patients
Methodological detailsrandom-effects logit meta-analysis, restricted maximum likelihood, Hartung-Knapp confidence intervals
- Random-effects logit meta-analysis
- Restricted maximum likelihood
- Hartung-Knapp confidence intervals
Pooled result
As reported in the abstract
Coronary artery disease (CAD) cases among scar-negative patients (Eight studies)
44 CAD cases among 468 scar-negative patients
Pooled prevalence
10.8% (95% confidence interval [CI] 7.4-15.4)
Further pooled results
Angiographic CAD, ≥70% stenosis, among scar-negative patients
- CAD cases among scar-negative patients (Five studies)
- 19 CAD cases among 271 scar-negative patients
- Pooled prevalence
- 7.6% (95% CI 4.4-12.6)
- These strata represented different study subsets and were not nested.
High-risk-pattern CAD among scar-negative patients
- CAD cases among scar-negative patients (Seven studies)
- 33 CAD cases among 679 scar-negative patients
- Pooled prevalence
- 4.9% (95% CI 2.2-10.6)
- 95% prediction interval
- 0.8-24.8%
- These strata represented different study subsets and were not nested.
Original publication
Prevalence of Angiographic Coronary Artery Disease in Systolic Heart Failure Without Infarct-Pattern Late Gadolinium Enhancement: A Systematic Review and Meta-analysis. Eur Heart J Cardiovasc Imaging. Published 2 November 2026. doi:10.
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