Diagnostic and Prognostic Value of Stress Cardiovascular Magnetic Resonance Imaging in Patients With Known or Suspected Coronary Artery Disease

A comprehensive systematic review and meta-analysis was conducted to assess the diagnostic accuracy and prognostic value of stress cardiovascular magnetic resonance imaging (CMR) in stable chest pain. The study aimed to provide contemporary quantitative data on the topic and shed light on the low-risk period for adverse cardiovascular (CV) events after a negative stress CMR result. A total of 64 studies involving 74,470 patients were included in the analysis, with data obtained from PubMed, Embase, Cochrane Database of Systematic Reviews, PROSPERO, and ClinicalTrials.gov.

The findings revealed that stress CMR exhibited high diagnostic accuracy, with a sensitivity of 81% and specificity of 86% for detecting functionally obstructive coronary artery disease. The presence of stress-inducible ischemia and late gadolinium enhancement (LGE) were associated with higher all-cause mortality, CV mortality, and major adverse cardiovascular events (MACEs). Subgroup analysis indicated that stress CMR had even higher diagnostic accuracy when suspected coronary artery disease was present or when 3-T imaging was used. Importantly, patients with normal stress CMR results had a lower risk of MACEs for at least 3.5 years after the test...Read more

Could this be a feasible routine investigation for stable chest pain?