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Exercise ECG Testing and Stress Cardiac Magnetic Resonance for Risk Prediction in Patients With Chronic Coronary Syndrome

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Exercise ECG Testing and Stress Cardiac Magnetic Resonance for Risk Prediction in Patients With Chronic Coronary Syndrome

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dc.contributor.author Marcos-Garces, Victor es_ES
dc.contributor.author Merenciano-Gonzalez, Héctor es_ES
dc.contributor.author Gabaldon-Perez, Ana es_ES
dc.contributor.author Nuñez-Marin, Gonzalo es_ES
dc.contributor.author Lorenzo-Hernandez, Miguel es_ES
dc.contributor.author Gavara-Doñate, Josep 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 Lopez-Lereu, Maria Pilar es_ES
dc.contributor.author Monmeneu, Jose Vicente es_ES
dc.contributor.author Chorro, Francisco Javier es_ES
dc.contributor.author Bodi, Vicente es_ES
dc.date.accessioned 2024-01-09T19:01:54Z
dc.date.available 2024-01-09T19:01:54Z
dc.date.issued 2022-01 es_ES
dc.identifier.issn 1932-7501 es_ES
dc.identifier.uri http://hdl.handle.net/10251/201656
dc.description.abstract [EN] Purpose: Vasodilator stress cardiac magnetic resonance (VS-CMR) has become crucial in the workup of patients with known or suspected chronic coronary syndrome (CCS). Whether traditional exercise ECG testing (ExECG) contributes prognostic information beyond VS-CMR is unclear. Methods: We retrospectively included 288 patients with known or suspected CCS who had undergone ExECG and subsequent VS-CMR in our institution. Clinical, ExECG, and VS-CMR variables were recorded. We defined the serious adverse events (SAE) as a combined endpoint of acute coronary syndrome, admission for heart failure, or all-cause death. Results: During a mean follow-up of 4.2 +/- 2.15 yr, we registered 27 SAE (15 admissions for acute coronary syndrome, eight admissions for heart failure, and four all-cause deaths). Once adjusted for clinical, ExECG, and VS-CMR parameters associated with SAE, the only independent predictors were HRmax in ExECG (HR = 0.98: 95% CI, 0.96-0.99; P = .01) and more extensive stress-induced perfusion defects (PDs, number of segments) in VS-CMR (HR = 1.19: 95% CI, 1.07-1.34; P < .01). Adding HRmax significantly improved the predictive power of the multivariable model for SAE, including PDs (continuous reclassification improvement index: 0.47: 95% CI, 0.10-0.81; P < .05). The annualized SAE rate was 1% (if PD < 2 segments and HRmax > 130 bpm), 2% (if PD < 2 segments and HRmax <= 130 bpm), 3.2% (if PD >= 2 segments and HRmax > 130 bpm), and 6.3% (if PD >= 2 segments and HRmax <= 130 bpm), P < .01, for the trend. In patients on beta-blocker therapy, however, only PDs in VS-CMR, but not HRmax, predicted SAE. Conclusions: We conclude that ExECG contributes significantly to prognostic information beyond VS-CMR in patients with known or suspected CCS. es_ES
dc.description.sponsorship This study was funded by "Instituto de Salud Carlos III" and "Fondos Europeos de Desarrollo Regional FEDER" (PIE15/00013, PI17/01836, PI20/00637, and CIBERCV16/11/00486 grants) and by Generalitat Valenciana (GV/2018/116 grant). es_ES
dc.language Inglés es_ES
dc.publisher Lippincott Williams & Wilkins es_ES
dc.relation.ispartof Journal of Cardiopulmonary Rehabilitation and Prevention es_ES
dc.rights Reserva de todos los derechos es_ES
dc.subject All-cause mortality es_ES
dc.subject Heart rate es_ES
dc.subject Perfusion defect es_ES
dc.subject Prognosis es_ES
dc.subject Stable coronary artery disease es_ES
dc.title Exercise ECG Testing and Stress Cardiac Magnetic Resonance for Risk Prediction in Patients With Chronic Coronary Syndrome es_ES
dc.type Artículo es_ES
dc.identifier.doi 10.1097/HCR.0000000000000621 es_ES
dc.relation.projectID info:eu-repo/grantAgreement/ISCIII/Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020 (ISCIII)/PI20%2F00637/ES/RESOLUCION DE LA OBSTRUCCION MICROVASCULAR TRAS UN INFARTO DE MIOCARDIO: EVALUACION DE LAS CONSECUENCIAS ESTRUCTURALES Y CLINICAS Y BUSQUEDA DE NUEVAS OPCIONES TERAPEUTICAS./ es_ES
dc.relation.projectID info:eu-repo/grantAgreement/MINECO//CB16%2F11%2F00486/ES/ENFERMEDADES CARDIOVASCULARES/ es_ES
dc.relation.projectID info:eu-repo/grantAgreement/MINECO//PIE15%2F00013/ES/A multidisciplinary project to advance in basic mechanisms, diagnosis, prediction, and prevention of cardiac damage in reperfused acute myocardial infarction/ es_ES
dc.relation.projectID info:eu-repo/grantAgreement/GVA//GV%2F2018%2F116/ es_ES
dc.relation.projectID info:eu-repo/grantAgreement/ISCIII//PI17%2F01836/ es_ES
dc.rights.accessRights Cerrado es_ES
dc.description.bibliographicCitation Marcos-Garces, V.; Merenciano-Gonzalez, H.; Gabaldon-Perez, A.; Nuñez-Marin, G.; Lorenzo-Hernandez, M.; Gavara-Doñate, J.; Pérez, N.... (2022). Exercise ECG Testing and Stress Cardiac Magnetic Resonance for Risk Prediction in Patients With Chronic Coronary Syndrome. Journal of Cardiopulmonary Rehabilitation and Prevention. 42(1):E7-E12. https://doi.org/10.1097/HCR.0000000000000621 es_ES
dc.description.accrualMethod S es_ES
dc.relation.publisherversion https://doi.org/10.1097/HCR.0000000000000621 es_ES
dc.description.upvformatpinicio E7 es_ES
dc.description.upvformatpfin E12 es_ES
dc.type.version info:eu-repo/semantics/publishedVersion es_ES
dc.description.volume 42 es_ES
dc.description.issue 1 es_ES
dc.identifier.pmid 34561369 es_ES
dc.relation.pasarela S\481719 es_ES
dc.contributor.funder Generalitat Valenciana 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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