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Vasodilator Stress CMR and All-Cause Mortality in Stable Ischemic Heart Disease A Large Retrospective Registry

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Vasodilator Stress CMR and All-Cause Mortality in Stable Ischemic Heart Disease A Large Retrospective Registry

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dc.contributor.author Marcos-Garces, Victor es_ES
dc.contributor.author Gavara, Jose es_ES
dc.contributor.author Monmeneu, Jose V. es_ES
dc.contributor.author Lopez-Lereu, Maria P. es_ES
dc.contributor.author Bosch, María J. es_ES
dc.contributor.author Merlos, Pilar es_ES
dc.contributor.author Pérez, Nerea es_ES
dc.contributor.author Rios-Navarro, César es_ES
dc.contributor.author De Dios, Elena es_ES
dc.contributor.author Bonanad, Clara es_ES
dc.contributor.author Racugno, Paolo es_ES
dc.contributor.author Bellver Navarro, Alejandro es_ES
dc.contributor.author Ventura Perez, Bruno es_ES
dc.contributor.author Aguilar Botella, Jose es_ES
dc.contributor.author Ventura, Silvia es_ES
dc.contributor.author Moratal, David es_ES
dc.date.accessioned 2021-09-14T03:33:14Z
dc.date.available 2021-09-14T03:33:14Z
dc.date.issued 2020-08 es_ES
dc.identifier.issn 1936-878X es_ES
dc.identifier.uri http://hdl.handle.net/10251/172303
dc.description.abstract [EN] OBJECTIVES: This study explored the association of ischemic burden, as measured by vasodilator stress cardiovascular magnetic resonance (CMR), with all-cause mortality and the effect of revascularization on all-cause mortality in patients with stable ischemic heart disease (SIHD). Background: In patients with SIHD, the association of ischemic burden, derived from vasodilator stress CMR, with all-cause mortality and its role for decision-making is unclear. METHODS: The registry consisted of 6,389 consecutive patients (mean age: 65 +/- 12 years; 38% women) who underwent vasodilator stress CMR for known or suspected SIHD. The ischemic burden (at stress first-pass perfusion imaging) was computed (17-segment model). The effect of CMR-related revascularization (within the following 3 months) on all-cause mortality was retrospectively explored using the electronic regional health system registry. RESULTS: During a 5.75-year median follow-up, 717 (11%) deaths were documented. In multivariable analyses, more extensive ischemic burden (per 1-segment increase) was independently related to all-cause mortality (hazard ratio: 1.04; 95% confidence interval: 1.02 to 1.07; p < 0.001). In 1,032 1:1 matched patients using a limited number of variables (516 revascularized, 516 non-revascularized), revascularization within the following 3 months was associated with less all-cause mortality only in patients with extensive CMR-related ischemia (>5 segments, n = 432; 10% vs. 24%; p = 0.01). CONCLUSIONS: In a large retrospective registry of unselected patients with known or suspected SIHD who underwent vasodilator stress CMR, extensive ischemic burden was related to a higher risk of long-term, all-cause mortality. Revascularization was associated with a protective effect only in the restricted subset of patients with extensive CMR-related ischemia. Further research will be needed to confirm this hypothesis-generating finding. es_ES
dc.description.sponsorship Dr. Marcos-Garces and Mr. Gavara contributed equally to the study. This work was supported by the Instituto de Salud Carlos III and co-funded by Fondo Europeo de Desarrollo Regional (FEDER) (grant numbers PI17/01836, PIE15/00013, CIBERCV16/11/00486). The authors have reported that they have no relationships relevant to the contents of this paper to disclose. es_ES
dc.language Inglés es_ES
dc.publisher Elsevier es_ES
dc.relation MINECO/PIE15/00013 es_ES
dc.relation.ispartof JACC: Cardiovascular Imaging es_ES
dc.rights Reserva de todos los derechos es_ES
dc.subject All-cause mortality es_ES
dc.subject Cardiovascular magnetic resonance es_ES
dc.subject Ischemic burden es_ES
dc.subject Ischemic heart disease es_ES
dc.subject Prognosis es_ES
dc.subject Revascularization es_ES
dc.subject.classification TECNOLOGIA ELECTRONICA es_ES
dc.title Vasodilator Stress CMR and All-Cause Mortality in Stable Ischemic Heart Disease A Large Retrospective Registry es_ES
dc.type Artículo es_ES
dc.identifier.doi 10.1016/j.jcmg.2020.02.027 es_ES
dc.relation.projectID info:eu-repo/grantAgreement/ISCIII//PI17%2F01836/ES/Estudio multidisciplinar de la obstrucción microvascular y su reparación tras un infarto agudo demiocardio: de la arteria coronaria a la microcirculación. Foco en el factor VEGF-A165b/ es_ES
dc.relation.projectID info:eu-repo/grantAgreement/MINECO//CB16%2F11%2F00486/ES/ENFERMEDADES CARDIOVASCULARES/ es_ES
dc.rights.accessRights Cerrado es_ES
dc.contributor.affiliation Universitat Politècnica de València. Departamento de Ingeniería Electrónica - Departament d'Enginyeria Electrònica es_ES
dc.description.bibliographicCitation Marcos-Garces, V.; Gavara, J.; Monmeneu, JV.; Lopez-Lereu, MP.; Bosch, MJ.; Merlos, P.; Pérez, N.... (2020). Vasodilator Stress CMR and All-Cause Mortality in Stable Ischemic Heart Disease A Large Retrospective Registry. JACC: Cardiovascular Imaging. 13(8):1674-1686. https://doi.org/10.1016/j.jcmg.2020.02.027 es_ES
dc.description.accrualMethod S es_ES
dc.relation.publisherversion https://doi.org/10.1016/j.jcmg.2020.02.027 es_ES
dc.description.upvformatpinicio 1674 es_ES
dc.description.upvformatpfin 1686 es_ES
dc.type.version info:eu-repo/semantics/publishedVersion es_ES
dc.description.volume 13 es_ES
dc.description.issue 8 es_ES
dc.relation.pasarela S\427972 es_ES
dc.contributor.funder Instituto de Salud Carlos III es_ES
dc.contributor.funder European Regional Development Fund es_ES
dc.contributor.funder Ministerio de Economía y Competitividad es_ES
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