Evidence map›Paper›PMID 21835377›Full record

ArticleJACC. Cardiovascular imaging2011

Stress myocardial perfusion imaging by CMR provides strong prognostic value to cardiac events regardless of patient's sex.

Otavio R Coelho-Filho, Luciana F Seabra, François-Pierre Mongeon, Shuaib M Abdullah, Sanjeev A Francis, Ron Blankstein, Marcelo F Di Carli, Michael Jerosch-Herold, Raymond Y Kwong

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Cardiovascular imaging, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
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  6. Trial
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  9. Review
  10. Article
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  12. Article
  13. Multimodality Imaging in the Detection of Ischemic Heart Disease in Women.Journal of cardiovascular development and disease · 2022
    Review
  14. Article
  15. Prognostic value of vasodilator stress perfusion cardiovascular magnetic resonance after inconclusive stress testing.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2021
    Article
  16. Review
  17. Article
  18. Long-term prognostic value of stress perfusion cardiovascular magnetic resonance in patients without known coronary artery disease.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2021
    Observational
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  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Otavio R Coelho-FilhoCardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
Luciana F Seabra
François-Pierre Mongeon
Shuaib M Abdullah
Sanjeev A Francis
Ron Blankstein
Marcelo F Di Carli
Michael Jerosch-Herold
Raymond Y Kwong

Funding

Prognostic Impact and Arrhythmic Potential of Peri-infarct Zone by Cardiac MRIR01HL091157 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI KWONG, RAYMOND Y · 2008 to 2012
$2.3M
NHLBI NIH HHS R01 HL091157
6 · The paper itself

Abstract

objectivesThe major aim of this study is to test the hypothesis that stress cardiac magnetic resonance (CMR) imaging can provide robust prognostic value in women presenting with suspected ischemia, to the same extent as in men.

backgroundCompelling evidence indicates that women with coronary artery disease (CAD) experience worse outcomes than men owing to a lack of early diagnosis and management. Numerous clinical studies have shown that stress CMR detects evidence of myocardial ischemia and infarction at high accuracy. Compared to nuclear scintigraphy, CMR is free of ionizing radiation, has high spatial resolution for imaging small hearts, and overcomes breast attenuation artifacts, which are substantial advantages when imaging women for CAD.

methodsWe performed stress CMR in 405 patients (168 women, mean age 58 ± 14 years) referred for ischemia assessment. CMR techniques included cine cardiac function, perfusion imaging during vasodilating stress, and late gadolinium enhancement imaging. All patients were followed for major adverse cardiac events (MACE).

resultsAt a median follow-up of 30 months, MACE occurred in 36 patients (9%) including 21 cardiac deaths and 15 acute myocardial infarctions. In women, CMR evidence of ischemia (ISCHEMIA) demonstrated strong association with MACE (unadjusted hazard ratio: 49.9, p < 0.0001). While women with ISCHEMIA(+) had an annual MACE rate of 15%, women with ISCHEMIA(-) had very low annual MACE rate (0.3%), which was not statistically different from the low annual MACE rate in men with ISCHEMIA(-) (1.1%). CMR myocardial ischemia score was the strongest multivariable predictor of MACE in this cohort, for both women and men, indicating robust cardiac prognostication regardless of sex.

conclusionsIn addition to avoiding exposure to ionizing radiation, stress CMR myocardial perfusion imaging is an effective and robust risk-stratifying tool for patients of either sex presenting with possible ischemia.

Indexed as

Coronary CirculationMagnetic Resonance Imaging, CineVasodilator AgentsAdultAgedBostonContrast MediaCoronary AngiographyDisease-Free SurvivalFemaleGadolinium DTPAHumansKaplan-Meier EstimateMaleMiddle AgedMyocardial InfarctionContrast MediaGadolinium DTPAVasodilator Agents

Identifiers

PMID21835377
PMCPMC3954523

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.