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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
dc.description.references Bodi, V., Sanchis, J., Lopez-Lereu, M. P., Nunez, J., Mainar, L., Monmeneu, J. V., … Llacer, A. (2007). Prognostic Value of Dipyridamole Stress Cardiovascular Magnetic Resonance Imaging in Patients With Known or Suspected Coronary Artery Disease. Journal of the American College of Cardiology, 50(12), 1174-1179. doi:10.1016/j.jacc.2007.06.016 es_ES
dc.description.references Vincenti, G., Masci, P. G., Monney, P., Rutz, T., Hugelshofer, S., Gaxherri, M., … Schwitter, J. (2017). Stress Perfusion CMR in Patients With Known and Suspected CAD. JACC: Cardiovascular Imaging, 10(5), 526-537. doi:10.1016/j.jcmg.2017.02.006 es_ES
dc.description.references Bodi, V., Husser, O., Sanchis, J., Núñez, J., Monmeneu, J. V., López-Lereu, M. P., … Llacer, Á. (2012). Prognostic Implications of Dipyridamole Cardiac MR Imaging: A Prospective Multicenter Registry. Radiology, 262(1), 91-100. doi:10.1148/radiol.11110134 es_ES
dc.description.references Katritsis, D. G., Mark, D. B., & Gersh, B. J. (2018). Revascularization in stable coronary disease: evidence and uncertainties. Nature Reviews Cardiology, 15(7), 408-419. doi:10.1038/s41569-018-0006-z es_ES
dc.description.references Kelle, S., Chiribiri, A., Vierecke, J., Egnell, C., Hamdan, A., Jahnke, C., … Gebker, R. (2011). Long-Term Prognostic Value of Dobutamine Stress CMR. JACC: Cardiovascular Imaging, 4(2), 161-172. doi:10.1016/j.jcmg.2010.11.012 es_ES
dc.description.references Caliendo, M., & Kopeinig, S. (2008). SOME PRACTICAL GUIDANCE FOR THE IMPLEMENTATION OF PROPENSITY SCORE MATCHING. Journal of Economic Surveys, 22(1), 31-72. doi:10.1111/j.1467-6419.2007.00527.x es_ES
dc.description.references Timmis, A., Raharja, A., Archbold, R. A., & Mathur, A. (2018). Validity of inducible ischaemia as a surrogate for adverse outcomes in stable coronary artery disease. Heart, 104(21), 1733-1738. doi:10.1136/heartjnl-2018-313230 es_ES
dc.description.references Hachamovitch, R., Hayes, S. W., Friedman, J. D., Cohen, I., & Berman, D. S. (2003). Comparison of the Short-Term Survival Benefit Associated With Revascularization Compared With Medical Therapy in Patients With No Prior Coronary Artery Disease Undergoing Stress Myocardial Perfusion Single Photon Emission Computed Tomography. Circulation, 107(23), 2900-2907. doi:10.1161/01.cir.0000072790.23090.41 es_ES
dc.description.references Hachamovitch, R., Rozanski, A., Shaw, L. J., Stone, G. W., Thomson, L. E. J., Friedman, J. D., … Berman, D. S. (2011). Impact of ischaemia and scar on the therapeutic benefit derived from myocardial revascularization vs. medical therapy among patients undergoing stress-rest myocardial perfusion scintigraphy. European Heart Journal, 32(8), 1012-1024. doi:10.1093/eurheartj/ehq500 es_ES
dc.description.references 2013 ESC guidelines on the management of stable coronary artery disease. (2013). European Heart Journal, 34(38), 2949-3003. doi:10.1093/eurheartj/eht296 es_ES
dc.description.references Doenst, T., Haverich, A., Serruys, P., Bonow, R. O., Kappetein, P., Falk, V., … Sigusch, H. (2019). PCI and CABG for Treating Stable Coronary Artery Disease. Journal of the American College of Cardiology, 73(8), 964-976. doi:10.1016/j.jacc.2018.11.053 es_ES
dc.description.references A Randomized Trial of Therapies for Type 2 Diabetes and Coronary Artery Disease. (2009). New England Journal of Medicine, 360(24), 2503-2515. doi:10.1056/nejmoa0805796 es_ES
dc.description.references Boden, W. E., O’Rourke, R. A., Teo, K. K., Hartigan, P. M., Maron, D. J., Kostuk, W. J., … Weintraub, W. S. (2007). Optimal Medical Therapy with or without PCI for Stable Coronary Disease. New England Journal of Medicine, 356(15), 1503-1516. doi:10.1056/nejmoa070829 es_ES
dc.description.references Van Nunen, L. X., Zimmermann, F. M., Tonino, P. A. L., Barbato, E., Baumbach, A., Engstrøm, T., … Pijls, N. H. J. (2015). Fractional flow reserve versus angiography for guidance of PCI in patients with multivessel coronary artery disease (FAME): 5-year follow-up of a randomised controlled trial. The Lancet, 386(10006), 1853-1860. doi:10.1016/s0140-6736(15)00057-4 es_ES
dc.description.references De Bruyne, B., Pijls, N. H. J., Kalesan, B., Barbato, E., Tonino, P. A. L., Piroth, Z., … Fearon, W. F. (2012). Fractional Flow Reserve–Guided PCI versus Medical Therapy in Stable Coronary Disease. New England Journal of Medicine, 367(11), 991-1001. doi:10.1056/nejmoa1205361 es_ES
dc.description.references Neumann, F.-J., Sousa-Uva, M., Ahlsson, A., Alfonso, F., Banning, A. P., Benedetto, U., … Head, S. J. (2018). 2018 ESC/EACTS Guidelines on myocardial revascularization. European Heart Journal, 40(2), 87-165. doi:10.1093/eurheartj/ehy394 es_ES
dc.description.references Al-Lamee, R., Thompson, D., Dehbi, H.-M., Sen, S., Tang, K., Davies, J., … Malik, I. S. (2018). Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial. The Lancet, 391(10115), 31-40. doi:10.1016/s0140-6736(17)32714-9 es_ES
dc.description.references Shaw, L. J., Hausleiter, J., Achenbach, S., Al-Mallah, M., Berman, D. S., Budoff, M. J., … Min, J. K. (2012). Coronary Computed Tomographic Angiography as a Gatekeeper to Invasive Diagnostic and Surgical Procedures. Journal of the American College of Cardiology, 60(20), 2103-2114. doi:10.1016/j.jacc.2012.05.062 es_ES
dc.description.references Herwig, A., & Weltermann, B. (2017). Study protocol for a matter of heart: a qualitative study of patient factors driving overuse of cardiac catheterisation. BMJ Open, 7(9), e017629. doi:10.1136/bmjopen-2017-017629 es_ES
dc.description.references Maron, D. J., Hochman, J. S., O’Brien, S. M., Reynolds, H. R., Boden, W. E., Stone, G. W., … Rosenberg, Y. (2018). International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial: Rationale and design. American Heart Journal, 201, 124-135. doi:10.1016/j.ahj.2018.04.011 es_ES


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