Adenosine cardiac magnetic resonance: follow-up of patients with very high cardiovascular risk

Background

Stress cardiac magnetic resonance with adenosine (CMR-A) is a valid test to rule out myocardial ischaemia. We follow-up a cohort of patients with CMR-A due to suspected myocardial ischaemia, considering patients with very high cardiovascular risk.

Methods

We included all patients with CMR-A between June 2009 and November 2012, considering two groups: those with a very high cardiovascular risk (prior myocardial infarction or/and Diabetes mellitus) and the rest of the patients. The follow-up was done in outpatient cardiology clinic or by phone. We analyse free-event survival considering: acute coronary syndrome (ACS), death for any cause, admission for heart failure (HF) or necessity of revascularization as endpoints. The statistical analysis was made with SPSS 20.0.

Results

The follow-up of 239 patients (180 male) was done. 134 (56%) were re-classified as high cardiovascular risk patients and 105 (44%) as non-high cardiovascular risk ones. The basal characteristics of each group are summarize in table 1.

Table 1 Characteristics of the patients with CMR-A to rule out myocardial ischaemia considering cardiovascular risk

CMR-A was positive for myocardial ischaemia in 83 patients (35%) and negative in 156 (65%). The follow-up median was 25 months, with events in 68 patients. The results of the test and the events during the follow-up in each group are attached in table 1.

The analysis of Kaplan-Meier survival curves (1 and 2), considering the cardiovascular risk and the result of the test, showed statistical differences only in very high cardiovascular risk patients (Long Rank test; p=0.024).

Figure 1

Conclusions

In this cohort of patients with very high cardiovascular risk, those with a negative result have fewer events in the follow-up. CMR-A allows a better classification of the global cardiovascular risk

Funding

There is not any funding to support this trial.