Trial reportCirculation2013
Stress cardiac magnetic resonance imaging provides effective cardiac risk reclassification in patients with known or suspected stable coronary artery disease.
Trial report in Circulation, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01821924 (Role of Stress CMR in Predicting Adverse Clinical Events in Patients With Known or Suspected Ischemic Heart Disease), which is not on this map. Cited by 36 papers, 4 of them syntheses that pooled it.
What it found
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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.
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.
Role of Stress CMR in Predicting Adverse Clinical Events in Patients With Known or Suspected Ischemic Heart Disease
Who cites it
36 citing papers in PubMed, 4 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Cost-effectiveness of cardiovascular magnetic resonance imaging compared to common strategies in the diagnosis of coronary artery disease: a systematic review.Heart failure reviews · 2023Pooled it
- Diagnostic and Prognostic Value of Stress Cardiovascular Magnetic Resonance Imaging in Patients With Known or Suspected Coronary Artery Disease: A Systematic Review and Meta-analysis.JAMA cardiology · 2023Pooled it
- Exercise cardiac magnetic resonance imaging: a feasibility study and meta-analysis.American journal of physiology. Regulatory, integrative and comparative physiology · 2018Pooled it
- Society for Cardiovascular Magnetic Resonance (SCMR) expert consensus for CMR imaging endpoints in clinical research: part I - analytical validation and clinical qualification.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2018Guideline
- Cardiac Magnetic Resonance Stress Perfusion Imaging for Evaluation of Patients With Chest Pain.Journal of the American College of Cardiology · 2019Trial
- Prognostic Value of Regadenoson Stress Perfusion CMR.Medical sciences (Basel, Switzerland) · 2026Article
- Association of left ventricular mass with discordant stress cardiac magnetic resonance and coronary angiography.European heart journal. Cardiovascular Imaging · 2026Observational
- Absence of long-term incremental prognostic value of inducible wall motion abnormalities on dipyridamole stress CMR in patients with suspected or known coronary artery disease.European radiology · 2025Article
- Stress Cardiovascular Magnetic Resonance Imaging for the Detection of Coronary Artery Disease.Reviews in cardiovascular medicine · 2023Review
- Complementary prognostic value of stress perfusion imaging and global coronary flow reserve derived from cardiovascular magnetic resonance: a long-term cohort study.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2023Article
- A Review of the Roles and Limitations of Noninvasive Imaging Methods for Investigating Cardiovascular Disease in Individuals with Obesity.Medical science monitor : international medical journal of experimental and clinical research · 2022Review
- Stress Cardiac Magnetic Resonance Myocardial Perfusion Imaging: JACC Review Topic of the Week.Journal of the American College of Cardiology · 2021Review
- Prognostic value of resting coronary sinus flow determined by phase-contrast cine cardiovascular magnetic resonance in patients with known or suspected coronary artery disease.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2021Article
- Prognostic value of perfusion cardiovascular magnetic resonance with adenosine triphosphate stress in stable coronary artery disease.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2021Article
- Stress CMR in patients with obesity: insights from the Stress CMR Perfusion Imaging in the United States (SPINS) registry.European heart journal. Cardiovascular Imaging · 2021Article
- 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 · 2021Observational
- Cardiovascular magnetic resonance predictors of heart failure in hypertrophic cardiomyopathy: the role of myocardial replacement fibrosis and the microcirculation.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2021Observational
- What Is the Clinical Impact of Stress CMR After the ISCHEMIA Trial?Frontiers in cardiovascular medicine · 2021Review
- Evaluation of Stress Cardiac Magnetic Resonance Imaging in Risk Reclassification of Patients With Suspected Coronary Artery Disease.JAMA cardiology · 2020Article
- Prognostic Value of Stress CMR Perfusion Imaging in Patients With Reduced Left Ventricular Function.JACC. Cardiovascular imaging · 2020Article
Corrections and comments
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Authors and funding
15 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundA recent large-scale clinical trial found that an initial invasive strategy does not improve cardiac outcomes beyond optimized medical therapy in patients with stable coronary artery disease. Novel methods to stratify at-risk patients may refine therapeutic decisions to improve outcomes. METHODS AND
resultsIn a cohort of 815 consecutive patients referred for evaluation of myocardial ischemia, we determined the net reclassification improvement of the risk of cardiac death or nonfatal myocardial infarction (major adverse cardiac events) incremental to clinical risk models, using guideline-based low (<1%), moderate (1% to 3%), and high (>3%) annual risk categories. In the whole cohort, inducible ischemia demonstrated a strong association with major adverse cardiac events (hazard ratio=14.66; P<0.0001) with low negative event rates of major adverse cardiac events and cardiac death (0.6% and 0.4%, respectively). This prognostic robustness was maintained in patients with previous coronary artery disease (hazard ratio=8.17; P<0.0001; 1.3% and 0.6%, respectively). Adding inducible ischemia to the multivariable clinical risk model (adjusted for age and previous coronary artery disease) improved discrimination of major adverse cardiac events (C statistic, 0.81-0.86; P=0.04; adjusted hazard ratio=7.37; P<0.0001) and reclassified 91.5% of patients at moderate pretest risk (65.7% to low risk; 25.8% to high risk) with corresponding changes in the observed event rates (0.3%/y and 4.9%/y for low and high risk posttest, respectively). Categorical net reclassification index was 0.229 (95% confidence interval, 0.063-0.391). Continuous net reclassification improvement was 1.11 (95% confidence interval, 0.81-1.39).
conclusionsStress cardiac magnetic resonance imaging effectively reclassifies patient risk beyond standard clinical variables, specifically in patients at moderate to high pretest clinical risk and in patients with previous coronary artery disease. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01821924.
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Registered trials
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.