Vasodilator stress cardiac magnetic resonance (CMR) detects ischemia whereas coronary CT angiography (CTA) detects atherosclerosis. The purpose of this study was to determine concordance and accuracy of vasodilator stress CMR and coronary CTA in the same subjects. We studied 151 consecutive subjects referred to detect or exclude suspected obstructive coronary artery disease (CAD) in patients without known disease or recurrent stenosis or ischemia in patients with previously treated CAD. Vasodilator stress CMR was performed on a 1.5 T scanner. CTA was performed on a 320-detector row system. Subjects were followed for cardiovascular events and downstream diagnostic testing. Subjects averaged 56 ± 12 years (60% male), and 62% had intermediate pre-test probability for obstructive CAD. Follow-up averaged 450 ± 115 days and was 100% complete. CMR and CTA agreed in 92% of cases (κ 0.81, p < 0.001). The event-free survival was 97% for non-ischemic and 39% for ischemic CMR (p < 0.0001). The event-free survival was 99% for non-obstructive and 36% for obstructive CTA (p < 0.0001). Using a reference standard including quantitative invasive angiography or major cardiovascular events, CMR and CTA had respective sensitivities of 93 and 98%; specificities of 96 and 96%; positive predictive values of 91 and 91%; negative predictive values of 97 and 99%; and accuracies of 95 and 97%. Non-ischemic vasodilator stress CMR or non-obstructive coronary CTA were highly concordant and each confer an excellent prognosis. CMR and CTA are both accurate for assessment of obstructive CAD in a predominantly intermediate risk population.
|Number of pages||11|
|Journal||International Journal of Cardiovascular Imaging|
|State||Published - Jan 2014|
Bibliographical noteFunding Information:
Acknowledgments This work was funded by the Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, USA (ZIA HL004607-15, ZIA HL006137-03, ZIA HL006138-03). The authors thank Gregory Henderson RT, Dennis Johnson RT, Christine Mancini RT, Shirley Rollison RT, Pamela Vincent RT, Marsha Block RN, Kathie Bronson CRNP, Jennifer Henry RN, Tracy Lowrey RN and Luis Rosario for expert help with imaging, patient care, and follow-up of study participants.
- Cardiac computed tomography
- Cardiac magnetic resonance imaging
- Coronary artery disease
- Myocardial perfusion imaging
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine