title: Prognostic value of dipyridamole stress cardiovascular magnetic resonance imaging in patients with known or suspected coronary artery disease.
abstract: OBJECTIVE
  We evaluated the prognostic value of dipyridamole stress cardiovascular magnetic resonance imaging (CMR) in patients with chest pain and known or suspected coronary artery disease.
  
  
  BACKGROUND
  Stress perfusion CMR has been incorporated in daily practice. Data on its prognostic value are preliminary.
  
  
  METHODS
  Dipyridamole stress CMR was performed in 420 patients with chest pain and known or suspected coronary artery disease. The extent (number of segments according to the 17-segment model) of abnormal wall motion at rest (AWM-rest), abnormal wall motion with dipyridamole (AWM-D), perfusion deficit (at stress first-pass perfusion imaging), and delayed enhancement (at late enhancement imaging) were analyzed.
  
  
  RESULTS
  During a median follow-up of 420 days, 41 major adverse cardiac events (MACE), including 9 cardiac deaths, 14 nonfatal myocardial infarctions, and 18 readmissions for unstable angina with documented abnormal angiography, were documented. The MACE were more frequent in patients with significant (>1 segment) AWM-rest (22% vs. 5%), AWM-D (21% vs. 4%), perfusion deficit (17% vs. 5%), and delayed enhancement (20% vs. 6%; p <0.0001 in all cases). In a multivariate analysis adjusted for baseline characteristics, the extent of AWM-D was independently related to MACE (hazard ratio [HR] 1.15 [95% confidence interval (CI) 1.06 to 1.24] per segment; p = 0.0006) and to major events (cardiac death or nonfatal myocardial infarction; HR 1.15 [95% CI 1.05 to 1.26] per segment; p = 0.002).
  
  
  CONCLUSIONS
  Dipyridamole stress CMR is useful for predicting the outcome of patients with known or suspected coronary artery disease.
authors.affiliation: Cardiology Department, University Clinic Hospital, University of Valencia, Valencia, Spain. vicentbodi@hotmail.com
authors.forename: Vicente
authors.initials: V
authors.lastname: Bodi
authors.forename: Juan
authors.initials: J
authors.lastname: Sanchis
authors.forename: Maria P
authors.initials: MP
authors.lastname: Lopez-Lereu
authors.forename: Julio
authors.initials: J
authors.lastname: Nunez
authors.forename: Luis
authors.initials: L
authors.lastname: Mainar
authors.forename: Jose V
authors.initials: JV
authors.lastname: Monmeneu
authors.forename: Oliver
authors.initials: O
authors.lastname: Husser
authors.forename: Eloy
authors.initials: E
authors.lastname: Dominguez
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Chorro
authors.forename: Angel
authors.initials: A
authors.lastname: Llacer
mesh_terms: D000368:Aged; D002637:Chest Pain / Q000175:diagnosis; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003327:Coronary Disease / Q000175:diagnosis*; D004176:Dipyridamole; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D004176:Dipyridamole