Cardiac magnetic resonance imaging findings and the risk of cardiovascular events in patients with recent myocardial infarction or suspected or known coronary artery disease: a systematic review of prognostic studies.
The goal of this study was to review the prognostic value of cardiac magnetic resonance (CMR) imaging findings for future cardiovascular events in patients with a recent myocardial infarction (MI) and patients with suspected or known coronary artery disease (CAD). Although the diagnostic value of CMR findings is established, the independent prognostic association with future cardiovascular events remains largely unclear. Studies published by February 2013, identified by systematic MEDLINE and EMBASE searches, were reviewed for associations between CMR findings (left ventricular ejection fraction [LVEF], wall motion abnormalities [WMA], abnormal myocardial perfusion, microvascular obstruction, late gadolinium enhancement, edema, and intramyocardial hemorrhage) and hard events (all-cause mortality, cardiac death, cardiac transplantation, and MI) or major adverse cardiovascular events (MACE) (hard events and other cardiovascular events defined by the authors of the evaluated papers). Fifty-six studies (n = 25,497) were evaluated. For patients with recent MI, too few patients were evaluated to establish associations between CMR findings and hard events. LVEF (range of adjusted hazard ratios [HRs]: 1.03 to 1.05 per % decrease) was independently associated with MACE. In patients with suspected or known CAD, WMA (adjusted HRs: 1.87 to 2.99), inducible perfusion defects (adjusted HRs: 3.02 to 7.77), LVEF (adjusted HRs: 0.72 to 0.82 per 10% increase), and infarction (adjusted HRs: 2.82 to 9.43) were independently associated with hard events, and the presence of inducible perfusion defects was associated with MACE (adjusted HRs: 1.76 to 3.21). The independent predictor of future cardiovascular events for patients with a recent MI was LVEF, and the predictors for patients with suspected or known CAD were WMA, inducible perfusion defects, LVEF, and presence of infarction.
Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands. Electronic address: h.elaidi@umcutrecht.nl.
Hamza
H
El Aidi
Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands.
Arthur
A
Adams
Julius Center of Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Karel G M
KG
Moons
Julius Center of Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands.
Hester M
HM
Den Ruijter
Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands.
Willem P Th M
WP
Mali
Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands.
Pieter A
PA
Doevendans
Division of Imaging Sciences and Biomedical Engineering, St. Thomas' Hospital, London, United Kingdom.
Eike
E
Nagel
Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands.
Simon
S
Schalla
Julius Center of Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Michiel L
ML
Bots
Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands.
Tim
T
Leiner
D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000209:etiology; D002318:Cardiovascular Diseases / Q000175:diagnosis; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis*; D003326:Coronary Circulation / Q000502:physiology; D005260:Female; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D009200:Myocardial Contraction / Q000502:physiology; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000502:physiology
D005682:Gadolinium
cardiac magnetic resonance; prognosis; systematic review