Evidence map›Paper›PMID 27059504›Full record

ArticleCirculation. Cardiovascular imaging2016

Stress Perfusion Cardiac Magnetic Resonance Imaging Effectively Risk Stratifies Diabetic Patients With Suspected Myocardial Ischemia.

Bobak Heydari, Yu-Hsiang Juan, Hui Liu, Siddique Abbasi, Ravi Shah, Ron Blankstein, Michael Steigner, Michael Jerosch-Herold, Raymond Y Kwong

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Cardiovascular imaging, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 3 pooled it
2.3field-weighted citation impact, top 13% of its field
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

21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Review
  6. Review
  7. Article
  8. Article
  9. Review
  10. Review
  11. Review
  12. Review
  13. Review
  14. Article
  15. Incremental prognostic value of coronary flow reserve determined by phase-contrast cine cardiovascular magnetic resonance of the coronary sinus in patients with diabetes mellitus.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2020
    Observational
  16. Article
  17. Article
  18. Non-Invasive Imaging in Diabetic Cardiomyopathy.Journal of cardiovascular development and disease · 2019
    Review
  19. Article
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Bobak HeydariFrom the Noninvasive Cardiovascular Imaging Program, Division of Cardiovascular Medicine, and Radiology, Departments of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (B.H., Y.-H.J., H.L., S.A., R.S., R.B., M.S., M.J.-H., R.Y.K.); Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan (Y.-H.J.).
Yu-Hsiang JuanFrom the Noninvasive Cardiovascular Imaging Program, Division of Cardiovascular Medicine, and Radiology, Departments of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (B.H., Y.-H.J., H.L., S.A., R.S., R.B., M.S., M.J.-H., R.Y.K.); Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan (Y.-H.J.).
Hui LiuFrom the Noninvasive Cardiovascular Imaging Program, Division of Cardiovascular Medicine, and Radiology, Departments of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (B.H., Y.-H.J., H.L., S.A., R.S., R.B., M.S., M.J.-H., R.Y.K.); Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan (Y.-H.J.).
Siddique AbbasiFrom the Noninvasive Cardiovascular Imaging Program, Division of Cardiovascular Medicine, and Radiology, Departments of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (B.H., Y.-H.J., H.L., S.A., R.S., R.B., M.S., M.J.-H., R.Y.K.); Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan (Y.-H.J.).
Ravi ShahFrom the Noninvasive Cardiovascular Imaging Program, Division of Cardiovascular Medicine, and Radiology, Departments of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (B.H., Y.-H.J., H.L., S.A., R.S., R.B., M.S., M.J.-H., R.Y.K.); Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan (Y.-H.J.).
Ron BlanksteinFrom the Noninvasive Cardiovascular Imaging Program, Division of Cardiovascular Medicine, and Radiology, Departments of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (B.H., Y.-H.J., H.L., S.A., R.S., R.B., M.S., M.J.-H., R.Y.K.); Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan (Y.-H.J.).
Michael SteignerFrom the Noninvasive Cardiovascular Imaging Program, Division of Cardiovascular Medicine, and Radiology, Departments of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (B.H., Y.-H.J., H.L., S.A., R.S., R.B., M.S., M.J.-H., R.Y.K.); Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan (Y.-H.J.).
Michael Jerosch-HeroldFrom the Noninvasive Cardiovascular Imaging Program, Division of Cardiovascular Medicine, and Radiology, Departments of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (B.H., Y.-H.J., H.L., S.A., R.S., R.B., M.S., M.J.-H., R.Y.K.); Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan (Y.-H.J.).
Raymond Y KwongFrom the Noninvasive Cardiovascular Imaging Program, Division of Cardiovascular Medicine, and Radiology, Departments of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (B.H., Y.-H.J., H.L., S.A., R.S., R.B., M.S., M.J.-H., R.Y.K.); Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan (Y.-H.J.). rykwong@partners.org.
Chang Gung Memorial Hospital · TW

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
Myocardial tissue architecture in heart failure: implications on physiology and fitnessK23HL127099 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI SHAH, RAVI · 2016 to 2019
$668k
NHLBI NIH HHS K23 HL127099NHLBI NIH HHS R01 HL091157
6 · The paper itself

Abstract

backgroundDiabetics remain at high risk of cardiovascular disease and mortality despite advancements in medical therapy. Noninvasive cardiac risk profiling is often more difficult in diabetics owing to the prevalence of silent ischemia with unrecognized myocardial infarction, reduced exercise capacity, nondiagnostic electrocardiographic changes, and balanced ischemia from diffuse epicardial coronary atherosclerosis and microvascular dysfunction. METHODS AND

resultsA consecutive cohort of 173 patients with diabetes mellitus (mean age, 61.7±11.9 years; 37% women) with suspected myocardial ischemia underwent stress perfusion cardiac magnetic resonance imaging. Patients were evaluated for adverse cardiac events after cardiac magnetic resonance imaging with mean follow-up time of 2.9±2.5 years. Mean hemoglobin A1c for the population was 7.9±1.8%. Primary end point was a composite of cardiac death and nonfatal myocardial infarction. Diabetics with no inducible ischemia (n=94) experienced an annualized event rate of 1.4% compared with 8.2% (P=0.0003) in those with inducible ischemia (n=79). Diabetics without late gadolinium enhancement or inducible ischemia had a low annual cardiac event rate (0.5% per year). The presence of inducible ischemia was the strongest unadjusted predictor (hazard ratio, 4.86; P<0.01) for cardiac death and nonfatal myocardial infarction. This association remained robust in adjusted stepwise multivariable Cox regression analysis (hazard ratio, 4.28; P=0.02). In addition, categorical net reclassification index using 5-year risk cutoffs of 5% and 10% resulted in reclassification of 43.4% of the diabetic cohort with net reclassification index of 0.38 (95% confidence interval, 0.20-0.56; P<0.0001).

conclusionsStress perfusion cardiac magnetic resonance imaging provided independent prognostic utility and effectively reclassified risk in patients with diabetes mellitus referred for ischemic assessment. Further evaluation is required to determine whether a noninvasive imaging strategy with cardiac magnetic resonance imaging can favorably affect downstream outcomes and improve cost-effectiveness of care in diabetics.

Indexed as

Diabetes MellitusAdultAgedAged, 80 and overContrast MediaFemaleGadolinium DTPAHumansMagnetic Resonance ImagingMaleMiddle AgedMyocardial IschemiaPrognosisRisk AssessmentRisk FactorsContrast MediaGadolinium DTPAdeathdiabetes mellitusischemiamagnetic resonance imagingmyocardial infarctionperfusion

Identifiers

PMID27059504
PMCPMC4827622
OpenAlexW2338742340

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.