CMR Stronger Predictor of MACE Than Single-Photon Emission Computed Tomography

HealthDay News – Cardiovascular magnetic resonance (CMR) is a stronger predictor of risk for major adverse cardiovascular events (MACEs) than single-photon emission computed tomography (SPECT), according to a study published online May 10 in the Annals of Internal Medicine.

John P. Greenwood, MB, ChB, PhD, from the University of Leeds in the United Kingdom, and colleagues established the ability of CMR and SPECT to predict MACEs in annual follow-up of the Clinical Evaluation of Magnetic Resonance Imaging in Coronary Heart Disease (CE-MARC) study for a minimum of 5 years. Complete follow-up was seen for 99% of the 752 recruited patients.

Researchers found that 16.6% of the 628 patients who underwent CMR, SPECT, and the reference standard test of X-ray angiography had at least 1 MACE. Abnormal findings on CMR and SPECT were strong and independent predictors of MACE (hazard ratio: 2.77 and 1.62, respectively; P<.001 and P=.014, respectively). After adjustment for other cardiovascular risk factors, angiography result, or stratification for initial patient treatment, only CMR remained a significant predictor.

“Five-year follow-up of the CE-MARC study indicates that compared with SPECT, CMR is a stronger predictor of risk for MACEs, independent of cardiovascular risk factors, angiography result, or initial patient treatment,” the authors wrote. “This further supports the role of CMR as an alternative to SPECT for the diagnosis and management of patients with suspected coronary heart disease.”

References

1. Greenwood JP, Herzog BA, Brown JM, et al. Prognostic value of cardiovascular magnetic resonance and single-photon emission computed tomography in suspected coronary heart disease: long-term follow-up of a prospective, diagnostic accuracy cohort study. Ann Intern Med. 2016. doi; 10.7326/M15-1801. 
2. Hunink MGM, Fleishchmann KE. The role of randomized and nonrandomized studies in evaluating diagnostic strategies. Ann Intern Med. 2016. doi: 10.7326/M16-0811.