Coronary disease & ACSMeta-analysis
Prognostic Value of Qualitative and Quantitative Stress Cardiac Magnetic Resonance (CMR) in Patients With Known or Suspected Coronary Artery Disease (CAD)
- Systematic review and meta-analysis
Authors' conclusion
The presence of myocardial ischemia on CMR is associated with worse clinical outcomes in patients with known or suspected CAD. Both qualitative and quantitative stress CMR assessments are helpful tools for predicting clinical outcomes.
Study context
- Population
- Patients with known or suspected CAD
- Participants
- 38,030 patients · 41 studies
- Comparison
- Positive vs negative stress CMR
- Outcome
- MACE (cardiac death, nonfatal myocardial infarction (MI), unstable angina, coronary revascularization) and cardiac hard events (cardiac death and nonfatal MI)
Pooled result
As reported in the abstract
MACE
Positive CMR vs Negative CMRHazard ratio (95% CI)
qualitative CMR
3.86(3.28–4.54)
quantitative CMR
4.60(1.60–13.21)
- No significant difference between qualitative and quantitative CMR in predicting major adverse cardiovascular events (MACE)
- P = 0.75
Further pooled results
| Outcome | Estimate | |
|---|---|---|
| Cardiac hard events, cardiac death, nonfatal MI, coronary revascularization, all-cause mortality (qualitative CMR studies) — Positive CMR vs Negative CMR · cardiac hard events | OR 7.21 (95% CI 4.99–10.41) | |
| Cardiac hard events, cardiac death, nonfatal MI, coronary revascularization, all-cause mortality (qualitative CMR studies) — Positive CMR vs Negative CMR · cardiac death | OR 5.63 (95% CI 2.46–12.92) | |
| Cardiac hard events, cardiac death, nonfatal MI, coronary revascularization, all-cause mortality (qualitative CMR studies) — Positive CMR vs Negative CMR · nonfatal MI | OR 7.46 (95% CI 3.49–15.96) | |
| Cardiac hard events, cardiac death, nonfatal MI, coronary revascularization, all-cause mortality (qualitative CMR studies) — Positive CMR vs Negative CMR · all-cause mortality | HR 1.66 (95% CI 1.12–2.47) | |
| 0.050.21520Ratio (log scale) |
| Outcome | OR (95% CI) |
|---|---|
| Cardiac hard events, cardiac death, nonfatal MI, coronary revascularization, all-cause mortality (qualitative CMR studies) — Positive CMR vs Negative CMR · coronary revascularization; CI as printed | 6.34 (3.42–1.75) |
Original publication
Prognostic Value of Qualitative and Quantitative Stress CMR in Patients With Known or Suspected CAD. JACC Cardiovasc Imaging. Published 23 August 2023. doi:10.1016/j.jcmg.2023.05.025
Summarised from the published abstract; every number is checked against it