PMID- 31582133
OWN - NLM
STAT- MEDLINE
DCOM- 20200520
LR  - 20210511
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 74
IP  - 14
DP  - 2019 Oct 8
TI  - Cardiac Magnetic Resonance Stress Perfusion Imaging for Evaluation of Patients 
      With Chest Pain.
PG  - 1741-1755
LID - S0735-1097(19)36270-9 [pii]
LID - 10.1016/j.jacc.2019.07.074 [doi]
AB  - BACKGROUND: Stress cardiac magnetic resonance imaging (CMR) has demonstrated 
      excellent diagnostic and prognostic value in single-center studies. OBJECTIVES: 
      This study sought to investigate the prognostic value of stress CMR and 
      downstream costs from subsequent cardiac testing in a retrospective multicenter 
      study in the United States. METHODS: In this retrospective study, consecutive 
      patients from 13 centers across 11 states who presented with a chest pain 
      syndrome and were referred for stress CMR were followed for a target period of 4 
      years. The authors associated CMR findings with a primary outcome of 
      cardiovascular death or nonfatal myocardial infarction using competing 
      risk-adjusted regression models and downstream costs of ischemia testing using 
      published Medicare national payment rates. RESULTS: In this study, 2,349 patients 
      (63 +/- 11 years of age, 47% female) were followed for a median of 5.4 years. 
      Patients with no ischemia or late gadolinium enhancement (LGE) by CMR, observed 
      in 1,583 patients (67%), experienced low annualized rates of primary outcome 
      (<1%) and coronary revascularization (1% to 3%), across all years of study 
      follow-up. In contrast, patients with ischemia+/LGE+ experienced a >4-fold higher 
      annual primary outcome rate and a >10-fold higher rate of coronary 
      revascularization during the first year after CMR. Patients with ischemia and LGE 
      both negative had low average annual cost spent on ischemia testing across all 
      years of follow-up, and this pattern was similar across the 4 practice 
      environments of the participating centers. CONCLUSIONS: In a multicenter U.S. 
      cohort with stable chest pain syndromes, stress CMR performed at experienced 
      centers offers effective cardiac prognostication. Patients without CMR ischemia 
      or LGE experienced a low incidence of cardiac events, little need for coronary 
      revascularization, and low spending on subsequent ischemia testing. (Stress CMR 
      Perfusion Imaging in the United States [SPINS]: A Society for Cardiovascular 
      Resonance Registry Study; NCT03192891).
CI  - Copyright (c) 2019 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Kwong, Raymond Y
AU  - Kwong RY
AD  - Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department 
      of Medicine and Department of Radiology, Brigham and Women's Hospital, Boston, 
      Massachusetts. Electronic address: rykwong@bwh.harvard.org.
FAU - Ge, Yin
AU  - Ge Y
AD  - Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department 
      of Medicine and Department of Radiology, Brigham and Women's Hospital, Boston, 
      Massachusetts.
FAU - Steel, Kevin
AU  - Steel K
AD  - Cardiology Division, San Antonio Military Medical Center, San Antonio, Texas.
FAU - Bingham, Scott
AU  - Bingham S
AD  - Revere Health, Provo, Utah.
FAU - Abdullah, Shuaib
AU  - Abdullah S
AD  - Veterans Administration North Texas Healthcare System, University of Texas 
      Southwestern Medical Center, Dallas, Texas.
FAU - Fujikura, Kana
AU  - Fujikura K
AD  - Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department 
      of Medicine and Department of Radiology, Brigham and Women's Hospital, Boston, 
      Massachusetts.
FAU - Wang, Wei
AU  - Wang W
AD  - Division of Sleep Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
FAU - Pandya, Ankur
AU  - Pandya A
AD  - Department of Health Policy and Management, Harvard T.H. Chan School of Public 
      Health, Boston, Massachusetts.
FAU - Chen, Yi-Yun
AU  - Chen YY
AD  - Noninvasive Cardiovascular Imaging Section, Cardiovascular Division, Department 
      of Medicine and Department of Radiology, Brigham and Women's Hospital, Boston, 
      Massachusetts.
FAU - Mikolich, J Ronald
AU  - Mikolich JR
AD  - Department of Cardiovascular Medicine, Sharon Regional Health System, Sharon, 
      Pennsylvania.
FAU - Boland, Sebastian
AU  - Boland S
AD  - Department of Cardiovascular Medicine, Sharon Regional Health System, Sharon, 
      Pennsylvania.
FAU - Arai, Andrew E
AU  - Arai AE
AD  - National Heart, Lung, and Blood Institute, National Institutes of Health, 
      Bethesda, Maryland.
FAU - Bandettini, W Patricia
AU  - Bandettini WP
AD  - National Heart, Lung, and Blood Institute, National Institutes of Health, 
      Bethesda, Maryland.
FAU - Shanbhag, Sujata M
AU  - Shanbhag SM
AD  - National Heart, Lung, and Blood Institute, National Institutes of Health, 
      Bethesda, Maryland.
FAU - Patel, Amit R
AU  - Patel AR
AD  - Cardiology Division, Department of Medicine, University of Chicago, Chicago, 
      Illinois.
FAU - Narang, Akhil
AU  - Narang A
AD  - Cardiology Division, Department of Medicine, University of Chicago, Chicago, 
      Illinois.
FAU - Farzaneh-Far, Afshin
AU  - Farzaneh-Far A
AD  - Division of Cardiology, University of Illinois at Chicago, Chicago, Illinois.
FAU - Romer, Benjamin
AU  - Romer B
AD  - Division of Cardiology, University of Illinois at Chicago, Chicago, Illinois.
FAU - Heitner, John F
AU  - Heitner JF
AD  - Division of Cardiology, New York Presbyterian-Brooklyn Methodist Hospital, 
      Brooklyn, New York.
FAU - Ho, Jean Y
AU  - Ho JY
AD  - Division of Cardiology, New York Presbyterian-Brooklyn Methodist Hospital, 
      Brooklyn, New York.
FAU - Singh, Jaspal
AU  - Singh J
AD  - Division of Cardiology, New York Presbyterian-Brooklyn Methodist Hospital, 
      Brooklyn, New York.
FAU - Shenoy, Chetan
AU  - Shenoy C
AD  - Cardiovascular Division, Department of Medicine, University of Minnesota Medical 
      School, Minneapolis, Minnesota.
FAU - Hughes, Andrew
AU  - Hughes A
AD  - Cardiovascular Division, Department of Medicine, University of Minnesota Medical 
      School, Minneapolis, Minnesota.
FAU - Leung, Steve W
AU  - Leung SW
AD  - Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, 
      University of Kentucky, Lexington, Kentucky.
FAU - Marji, Meera
AU  - Marji M
AD  - Gill Heart and Vascular Institute, Division of Cardiovascular Medicine, 
      University of Kentucky, Lexington, Kentucky.
FAU - Gonzalez, Jorge A
AU  - Gonzalez JA
AD  - Division of Cardiology and Radiology, Scripps Clinic, La Jolla, California.
FAU - Mehta, Sandeep
AU  - Mehta S
AD  - Division of Cardiology and Radiology, Scripps Clinic, La Jolla, California.
FAU - Shah, Dipan J
AU  - Shah DJ
AD  - Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas.
FAU - Debs, Dany
AU  - Debs D
AD  - Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas.
FAU - Raman, Subha V
AU  - Raman SV
AD  - Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio 
      State University, Columbus, Ohio.
FAU - Guha, Avirup
AU  - Guha A
AD  - Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio 
      State University, Columbus, Ohio.
FAU - Ferrari, Victor A
AU  - Ferrari VA
AD  - Cardiovascular Division, Perelman School of Medicine, Hospital of the University 
      of Pennsylvania, Philadelphia, Pennsylvania.
FAU - Schulz-Menger, Jeanette
AU  - Schulz-Menger J
AD  - Charite, Medical Faculty of the Humboldt University, Experimental and Clinical 
      Research Center, Berlin, and Helios Clinics, Cardiology, Berlin, Germany.
FAU - Hachamovitch, Rory
AU  - Hachamovitch R
AD  - Division of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Stuber, Matthias
AU  - Stuber M
AD  - Department of Radiology, University Hospital, University of Lausanne, Lausanne, 
      Switzerland.
FAU - Simonetti, Orlando P
AU  - Simonetti OP
AD  - Division of Cardiovascular Medicine, Department of Internal Medicine, The Ohio 
      State University, Columbus, Ohio.
LA  - eng
SI  - ClinicalTrials.gov/NCT03192891
GR  - K23 HL132011/HL/NHLBI NIH HHS/United States
GR  - R01 HL091157/HL/NHLBI NIH HHS/United States
GR  - T32 HL007381/HL/NHLBI NIH HHS/United States
GR  - T32 HL094301/HL/NHLBI NIH HHS/United States
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
CIN - J Am Coll Cardiol. 2019 Oct 8;74(14):1756-1759. PMID: 31582134
MH  - Aged
MH  - Chest Pain/*diagnostic imaging/epidemiology
MH  - Coronary Angiography/*methods
MH  - Coronary Artery Disease/*diagnostic imaging/epidemiology
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - Myocardial Perfusion Imaging/*methods
MH  - Retrospective Studies
PMC - PMC8109181
MID - NIHMS1695936
OTO - NOTNLM
OT  - cost of care
OT  - prognosis
OT  - stress cardiac magnetic resonance imaging
EDAT- 2019/10/05 06:00
MHDA- 2020/05/21 06:00
PMCR- 2021/05/10
CRDT- 2019/10/05 06:00
PHST- 2019/03/08 00:00 [received]
PHST- 2019/07/08 00:00 [revised]
PHST- 2019/07/11 00:00 [accepted]
PHST- 2019/10/05 06:00 [entrez]
PHST- 2019/10/05 06:00 [pubmed]
PHST- 2020/05/21 06:00 [medline]
PHST- 2021/05/10 00:00 [pmc-release]
AID - S0735-1097(19)36270-9 [pii]
AID - 10.1016/j.jacc.2019.07.074 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2019 Oct 8;74(14):1741-1755. doi: 10.1016/j.jacc.2019.07.074.