Does a lower stress perfusion CMR-derived MPRI (≤1.47) predict increased risk of MACE in patients with ischemic symptoms but no overt CAD?
Stress perfusion CMR-derived MPRI is an independent predictor of medium-term MACE in patients with ischemic symptoms but no overt CAD.
OBJECTIVES: This study investigated the prognosis of coronary microvascular disease (CMD) as determined by stress perfusion cardiac magnetic resonance (CMR) in patients with ischemic symptoms but without significant coronary artery disease (CAD). BACKGROUND: Patients with CMD have poorer prognosis with various cardiac diseases. The myocardial perfusion reserve index (MPRI) derived from noninvasive stress perfusion CMR has been established to diagnose microvascular angina with a threshold MPRI 1.47 (hazard ratio HR: 3.14; 95% confidence interval CI: 1.58 to 6.25; p = 0.001). Multivariate Cox regression after adjusting for age and hypertension demonstrated that MPRI was an independent predictor of MACE (HR: 0.10; 95% CI: 0.03 to 0.34; p < 0.001). CONCLUSIONS: Stress perfusion CMR-derived MPRI is an independent imaging marker that predicts MACE in patients with ischemic symptom and no overt CAD over the medium term.
Zhou et al. (Wed,) studied this question.