Prognostic Value of Regadenoson Stress Perfusion CMR

Area of Science:

• Cardiology
• Radiology
• Medical Imaging

Background:

• Regadenoson is a widely used vasodilator stress agent for cardiac magnetic resonance (CMR) imaging.
• The long-term prognostic value of regadenoson stress-CMR in patients with myocardial ischemia requires further investigation.

Purpose of the Study:

• To evaluate the prognostic value of regadenoson stress-CMR in predicting major adverse cardiovascular events.
• To assess the independent predictive value of inducible ischemia and late gadolinium enhancement (LGE) on patient outcomes.

Main Methods:

• Retrospective analysis of 698 regadenoson stress-CMR studies with >3 months follow-up.
• Assessment of inducible ischemia and LGE using standardized criteria.
• Composite endpoint: cardiovascular death, myocardial infarction, late revascularization, or unstable angina hospitalization.
• Survival analysis using Kaplan-Meier curves and Fine-Gray competing-risks model.

Main Results:

• Inducible ischemia was identified in 27.5% of patients.
• Patients with inducible ischemia had a significantly higher incidence of composite events (8.25 times higher risk).
• Inducible ischemia independently predicted adverse outcomes (HR 4.50, p=0.001).
• LGE was not an independent predictor of adverse outcomes (HR 1.28, p=0.63).

Conclusions:

• Regadenoson stress-CMR provides reliable medium-term risk stratification for patients with suspected or known coronary artery disease.
• The presence of inducible ischemia detected by regadenoson stress-CMR is a strong independent predictor of major cardiovascular events.
• This highlights the prognostic significance and clinical utility of identifying inducible ischemia with this imaging technique.