Key result
Abstract reports no quantitative results on stress perfusion CMR predicting outcomes in ischaemic LV dysfunction.
Why the study?
Randomized trials in stable CAD have failed to link inducible ischaemia with outcomes, but often excluded patients with impaired LV function, leaving the prognostic impact of ischaemia in severe ischaemic LV dysfunction unclear.
Does the presence and extent of inducible ischaemia on stress perfusion CMR predict clinical outcomes and response to PCI in patients with severe ischaemic left ventricular dysfunction?
RCT
Yes
Does the presence and extent of inducible ischaemia on stress perfusion CMR predict clinical outcomes and response to PCI in patients with severe ischaemic left ventricular dysfunction?
Answers are grounded in this paper and cite their sources.
This study investigates whether the presence and extent of inducible ischaemia on CMR can predict clinical outcomes and the therapeutic benefit of PCI in patients with severe ischaemic left ventricular dysfunction.
Retrospective observational data suggest that the presence and extent of inducible myocardial ischaemia predict future adverse cardiac events in patients with ischaemic heart disease. However, several randomized trials have failed to identify an association between the burden of inducible ischaemia and outcomes in patients with stable coronary artery disease (CAD) assigned to medical therapy alone or revascularization.1,2 Despite this, the presence and extent of ischaemia are commonly used to guide revascularization of stable patients. Notably, many of these analyses excluded patients with impaired left ventricular (LV) function. REVIVED-BCIS2 was a prospective, multi-centre, randomized controlled trial, investigating whether percutaneous coronary intervention (PCI) improved clinical outcomes in patients with severe ischaemic LV dysfunction (ILVD), compared with optimal medical therapy (OMT) alone.3,4 Whilst ischaemia testing was not mandated by protocol, it was performed as part of routine clinical practice in selected patients. Based on these data, we sought to determine whether the presence and extent of ischaemia detected on stress perfusion cardiac magnetic resonance (CMR) imaging predict clinical outcomes and response to PCI, in patients with ILVD.
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Morgan et al. (2024) conducted an RCT in severe ischaemic LV dysfunction (ILVD). percutaneous coronary intervention (PCI) vs. optimal medical therapy (OMT) alone was evaluated on clinical outcomes. The abstract outlines the objective to determine if ischaemia on stress perfusion CMR predicts outcomes and PCI response in ischaemic LV dysfunction, but reports no quantitative results.
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