Key result
In patients with non-ischemic cardiomyopathy, the presence of myocardial scar detected by cardiac magnetic resonance was associated with a significantly higher risk of major adverse cardiac events (HR 3.40).
Why the study?
Does the presence of myocardial scar on CMR predict adverse cardiovascular and arrhythmic events in patients with non-ischemic cardiomyopathy?
Meta-Analysis (n=2,747)
Does the presence of myocardial scar on CMR predict adverse cardiovascular and arrhythmic events in patients with non-ischemic cardiomyopathy?
Effect estimate: HR 3.40 (95% CI 2.47-4.69)
p-value: p=<0.00001
CMR-detected myocardial scar is a powerful independent predictor of adverse cardiovascular and arrhythmic events in non-ischemic cardiomyopathy, suggesting it could improve risk stratification for ICD placement beyond LVEF alone.
May support scar-based risk stratification in non-ischemic cardiomyopathy; leaves open prospective validation for ICD decisions.
In patients with non-ischemic cardiomyopathy (NICM), risk stratification for sudden cardiac death (SCD) and selection of patients who would benefit from prophylactic implantable cardioverter-defibrillators remains challenging. We aim to discuss the evidence of cardiac magnetic resonance (CMR)-derived myocardial scar for the prediction of adverse cardiovascular outcomes in NICM. From the 15 studies analyzed, with a total of 2747 patients, the average prevalence of myocardial scar was 41%. In patients with myocardial scar, the risk for adverse cardiac events was more than 3-fold higher, and risk for arrhythmic events 5-fold higher, as compared to patients without scar. Based on the available observational, single center studies, CMR scar assessment may be a promising new tool for SCD risk stratification, which merits further investigation.
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Kim et al. (2015) conducted a meta-analysis in Non-Ischemic Cardiomyopathy (n=2,747). Presence of myocardial scar on cardiac magnetic resonance (CMR) vs. Absence of myocardial scar was evaluated on Major adverse cardiac events (MACE) (HR 3.40, 95% CI 2.47-4.69, p=<0.00001). In patients with non-ischemic cardiomyopathy, the presence of myocardial scar detected by cardiac magnetic resonance was associated with a significantly higher risk of major adverse cardiac events (HR 3.40).
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