June 15, 2004Circulation
Prognosis in Women With Myocardial Ischemia in the Absence of Obstructive Coronary Disease
Why the study?
Does abnormal MRS predict cardiovascular events in women with suspected myocardial ischemia but no obstructive CAD?
Structured PICO
Does abnormal MRS predict cardiovascular events in women with suspected myocardial ischemia but no obstructive CAD?
P
Population
426 women referred for coronary angiography for suspected myocardial ischemia, comprising 60 with no CAD/normal MRS, 14 with no CAD/abnormal MRS, and 352 with CAD.
I
Intervention
Abnormal phosphorus-31 nuclear magnetic resonance spectroscopy (MRS) during handgrip stress testing (stress-induced reduction in myocardial phosphocreatine-adenosine triphosphate ratio)
C
Comparator
Normal MRS (in women without CAD) and a reference group of women with CAD
O
Outcome
Composite of cardiovascular events (death, myocardial infarction, heart failure, stroke, other vascular events, and hospitalization for unstable angina) at 3 yearscomposite
Abnormal myocardial energetics on MRS identifies women without obstructive CAD who are at increased risk for adverse cardiovascular events, particularly hospitalization for unstable angina.
Authors
Discussion
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Implication
Abnormal MRS may stratify risk in women without obstructive CAD; leaves open whether energetics-targeted interventions improve outcomes.
Cite This Study
Johnson et al. (2004) studied this question.