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Cohort study

Sex-Specific Stress Perfusion Cardiac Magnetic Resonance Imaging in Suspected Ischemic Heart Disease

JACC Cardiovasc ImagingPublished

  • Registry-based cohort study (secondary analysis of the SPINS registry)
  • multicentre
Read the original article ↗

Authors' conclusion

Stress CMR demonstrated excellent prognostic performance with lower rates of invasive coronary angiography referral in women.

Study context

Population
Patients with suspected cardiovascular disease (CVD) undergoing stress perfusion cardiac magnetic resonance (CMR), SPINS Registry (US)1,104 women (47%)
Participants
2,349 patients
Exposure
Women vs men; abnormal vs normal stress CMR
  • Womenn = 1,104
Outcome
Composite of:
  • CV death
  • Nonfatal MI
Follow-up
5.4-year median

Main finding

CV death or nonfatal MI, by sex and CMR result

Hazard ratio

2.64

95% CI 1.20–5.90

P = 0.02

By group

Women, normal CMR

0.54%/y

Men, normal CMR

0.75%/y

Women, abnormal CMR

3.74%/y

Abnormal stress CMR vs Normal stress CMR
HR 2.64 (95% CI 1.20–5.90); P = 0.02

As reported in the abstract

Observational data: associations, not effects.

Secondary outcomes

OutcomeHR (95% CI)P value
Secondary outcome (hospitalization for unstable angina or HF, late unplanned CABG) — Abnormal stress CMR vs Normal stress CMR · independent predictor2.09 (1.43–3.08)P < 0.0001

Chest pain prevalence

P < 0.0001

Invasive coronary angiography · 90 days after CMR

P = 0.0001

OutcomeWomenMenEstimateP value
Secondary outcome (hospitalization for unstable angina or HF, late unplanned CABG) — Women, abnormal CMR vs Women, normal CMRP < 0.0001
Downstream costs · 90 days after CMR$114$171P = 0.001
  • Secondary outcome (hospitalization for unstable angina or HF, late unplanned CABG): Women, abnormal CMR 9.8%/y
  • Secondary outcome (hospitalization for unstable angina or HF, late unplanned CABG): Women, normal CMR 1.6%/y

Diagnostic image quality

No effect of sex on diagnostic image quality

Original publication

Sex-Specific Stress Perfusion Cardiac Magnetic Resonance Imaging in Suspected Ischemic Heart Disease. JACC Cardiovasc Imaging. Published 8 February 2023. doi:10.1016/j.jcmg.2022.11.025
Read the original article ↗PubMedCite RIS · BibTeX

Summarised from the published abstract; every number is checked against it