MRI Cardiac Stress Test Predicts Death From Heart Disease

TUESDAY, Feb. 26, 2019 — Stress cardiac magnetic resonance imaging (CMR) can predict mortality in patients with known or suspected coronary artery disease (CAD), according to a study published online Feb. 8 in JAMA Cardiology.

John F. Heitner, M.D., from the New York Presbyterian Brooklyn Methodist Hospital in New York City, and colleagues used data from 9,151 consecutive patients with known or suspected CAD who underwent clinical vasodilator stress CMR to see if the imaging could predict mortality. Mortality was determined through the U.S. Social Security Death Index.

The researchers found that 51.8 percent of patients had an abnormal exam and 16.6 percent died during a median of 5.0 years of follow-up. The addition of stress CMR improved prediction of mortality in two different risk models and improved risk reclassification by a net of 11.4 percent. There was a strong association between an abnormal stress CMR and mortality in all patients, patients with and without a history of CAD, and patients with normal and abnormal left ventricular ejection fraction when adjusting for patient age, sex, and cardiac risk factors.

“There are a number of reasons for the limited use of stress CMR, including availability of good quality laboratories, exclusion of patients who cannot undergo magnetization, and a lack of data on patient outcomes,” a coauthor said in a statement. “With the findings from this study suggesting that stress CMR is effective in predicting mortality, we provide a strong basis for a head-to-head study between stress CMR and other modalities.”

Two authors disclosed financial ties to the imaging industry.

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Posted: February 2019

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