Why the study?
Does cardiovascular magnetic resonance (CMR) lead to clinically important changes in management in patients who activate the primary percutaneous coronary intervention (PPCI) pathway?
Does cardiovascular magnetic resonance (CMR) lead to clinically important changes in management in patients who activate the primary percutaneous coronary intervention (PPCI) pathway?
A formal consensus of cardiologists identified five specific subgroups of patients activating the PPCI pathway in whom CMR is expected to lead to clinically important changes in management.
Supports CMR in five PPCI subgroups to guide management changes; extends consensus recommendations for targeted imaging in acute pathways.
OBJECTIVE: To define important changes in management arising from the use of cardiovascular magnetic resonance (CMR) in patients who activate the primary percutaneous coronary intervention (PPCI) pathway. DESIGN: Formal consensus study using literature review and cardiologist expert opinion to formulate consensus statements and setting up a consensus panel to review the statements (by completing a web-based survey, attending a face-to-face meeting to discuss survey results and modify the survey to reflect group discussion and completing the modified survey to determine which statements were in consensus). PARTICIPANTS: Formulation of consensus statements: four cardiologists (two CMR and two interventional) and six non-clinical researchers. Formal consensus: seven cardiologists (two CMR and three interventional, one echocardiography and one heart failure). Forty-nine additional cardiologists completed the modified survey. RESULTS: Thirty-seven draft statements describing changes in management following CMR were generated; these were condensed into 12 statements and reviewed through the formal consensus process. Three of 12 statements were classified in consensus in the first survey; these related to the role of CMR in identifying the cause of out-of-hospital cardiac arrest, providing a definitive diagnosis in patients found to have unobstructed arteries on angiography and identifying patients with left ventricular thrombus. Two additional statements were in consensus in the modified survey, relating to the ability of CMR to identify patients who have a poor prognosis after PPCI and assess ischaemia and viability in patients with multivessel disease. CONCLUSION: There was consensus that CMR leads to clinically important changes in management in five subgroups of patients who activate the PPCI pathway.
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Pufulete et al. (2017) studied Patients who activate the primary percutaneous coronary intervention (PPCI) pathway (n=66). Cardiovascular magnetic resonance (CMR) was evaluated on Consensus statements describing clinically important changes in management following CMR. Expert consensus identified that cardiovascular magnetic resonance leads to clinically important changes in management in five subgroups of patients who activate the primary PCI pathway.
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