Author + information
- Jiazuo H. Feng,
- Ravi Shah,
- Siddique Abbasi,
- Otávio Coelho Filho,
- Bobak Heydari,
- Ron Blankstein,
- Michael Steigner,
- Michael Jerosch-Herold and
- Raymond Kwong
The utility of stress-perfusion cardiac MRI (SP-CMR) in diabetes has not been extensively investigated. We hypothesized that SP-CMR risk stratifies diabetics for major adverse cardiac events (MACE).
We enrolled 143 diabetics (50 female (35%), mean age 61 ± 12) referred for SP-CMR. Standard protocols for vasodilator SP-CMR in our laboratory were performed to assess inducible ischemia during first pass perfusion with 0.1 mmol/kg gadolinium, followed by late gadolinium enhancement (LGE) and cine imaging. Clinical follow-up was performed for MACE (CV death/MI).
Of our 143 diabetics, 35 (25%) had prior MI, 116 (82%) had hypertension, 29 (20%) used tobacco. Patients with an abnormal SP-CMR were more likely to have prior MI (p<0.0001) or angiographic CAD (p<0.0001). The presence of inducible ischemia (LRχ2= 7.89, HR = 5.88, p=0.005; Figure 1) and tobacco use (LRχ2= 6.66, HR = 3.02, p < 0.01) were strongly associated with MACE in univariable Cox analysis and survival analysis. In a best-overall multivariable Cox regression model including all CMR and clinical/demographic indices, inducible ischemia was independently associated with hazard of MACE after adjustment for age and history of coronary artery disease (CAD). The annual event rate for MACE in diabetic patients with a positive SP-CMR was 10.6%, while those patients who were negative had a rate of 1.7%.
SP-CMR is a robust, non-invasive method of identifying patients with diabetes who are at risk for future MACE.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Imaging: MRI I Prognostic Value of CMR
Abstract Category: 19. Imaging: MRI
Presentation Number: 1137-318
- 2013 American College of Cardiology Foundation