Key result
Stress cardiac magnetic resonance imaging is an accurate and cost-effective modality with excellent negative predictive value that can safely serve as a gatekeeper for invasive angiography in stable CAD.
Why the study?
Non-invasive testing is often the first step in evaluating stable CAD, and this review focuses on recent advances in understanding how stress CMR can guide patient care.
Does stress CMR provide accurate diagnosis and equivalent clinical outcomes compared to coronary angiography with FFR in patients with stable coronary artery disease?
Does stress CMR provide accurate diagnosis and equivalent clinical outcomes compared to coronary angiography with FFR in patients with stable coronary artery disease?
Stress CMR is an accurate, cost-effective imaging modality with excellent negative predictive value that can safely serve as a gatekeeper for invasive angiography in patients with stable CAD.
May support stress CMR to triage stable CAD patients; leaves open randomized outcome trials versus FFR.
PURPOSE OF REVIEW: Non-invasive testing is often the first step in the evaluation of stable coronary artery disease (CAD). Stress cardiac magnetic resonance imaging (CMR) is an established modality with high diagnostic accuracy and prognostic value. This review will focus on the recent advances in understanding how stress CMR can help guide patient care. RECENT FINDINGS: Diagnostic accuracy of stress CMR has been validated against coronary angiography with fractional flow reserve (FFR) in patients with stable CAD. Large registry data have shown stress CMR to have important prognostic importance and that its cost-effectiveness compares favorably to alternatives. In patients with stable CAD, guidance using a CMR based strategy led to equivalent outcomes when compared to coronary angiography with FFR. SUMMARY: In persons with stable CAD, Stress CMR is an accurate and cost-effective imaging modality that should be considered in patients at intermediate pre-test probability of CAD. Prognostic studies have shown it to have excellent negative predictive value and that it can safely serve as a "gatekeeper" for invasive angiography.
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Ge et al. (2020) conducted a review in Stable coronary artery disease (CAD). Stress cardiac magnetic resonance imaging (CMR) vs. Coronary angiography with fractional flow reserve (FFR) was evaluated. Stress cardiac magnetic resonance imaging is an accurate and cost-effective modality with excellent negative predictive value that can safely serve as a gatekeeper for invasive angiography in stable CAD.
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