Background:Recurrence of cardiovascular events remains a substantial cause of mortality and morbidity among patients with previous coronary revascularization. The aim was to assess the prognostic value of stress cardiovascular magnetic resonance (CMR) parameters in patients with history of percutaneous coronary intervention.Methods:Between 2011 and 2014, consecutive patients with history of percutaneous coronary intervention referred for stress perfusion CMR were followed for the occurrence of major adverse cardiovascular events (MACEs), defined by cardiovascular death or nonfatal myocardial infarction. Patients with prior coronary artery bypass graft were excluded. Univariable and multivariable Cox regressions were performed to determine the prognostic value of each parameter.Results:Of 1762 patients who completed the CMR protocol, 1624 patients (81.7% male, mean age 67.9±10.4 years) completed the follow-up (median [interquartile range], 6.7 [5.6–7.3] years); 244 experienced a MACE (15.0%). Stress CMR was well tolerated. Using Kaplan-Meier analysis, inducible ischemia and late gadolinium enhancement were significantly associated with the occurrence of MACE (hazard ratio, 2.70 [95% CI, 2.11–3.46], P<0.001; and hazard ratio: 1.52 [95% CI, 1.16–1.99], P=0.002; respectively). In multivariable Cox regression, inducible ischemia and late gadolinium enhancement were independent predictors of a higher incidence of MACE (hazard ratio, 2.79 [95% CI, 2.16–3.60]; P<0.001 and hazard ratio, 1.41 [95% CI, 1.04–1.90], P=0.032; respectively).Conclusions:Inducible ischemia and late gadolinium enhancement assessed by stress CMR were independently associated with MACE in patients with history of percutaneous coronary intervention.

中文翻译：

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有经皮冠状动脉介入治疗史患者的压力心血管磁共振的长期预后价值

背景：心血管事件的复发仍然是既往冠状动脉血运重建患者死亡和发病的重要原因。目的是评估有经皮冠状动脉介入治疗史患者的负荷心血管磁共振 (CMR) 参数的预后价值。主要不良心血管事件 (MACE) 的发生，定义为心血管死亡或非致命性心肌梗死。既往有冠状动脉旁路移植术的患者被排除在外。进行单变量和多变量 Cox 回归以确定每个参数的预后价值。 结果：在 1762 名完成 CMR 协议的患者中，1624 名患者（81.7% 男性，平均年龄 67.9±10.4 岁）完成了随访（中位数 [四分位距]，6.7 [5.6-7.3] 岁）；244 人经历了 MACE (15.0%)。应力 CMR 耐受性良好。使用 Kaplan-Meier 分析，诱导性缺血和钆延迟增强与 MACE 的发生显着相关（风险比，2.70 [95% CI，2.11-3.46]，P <0.001；和风险比：1.52 [95% CI，1.16–1.99]，P = 0.002；分别）。在多变量 Cox 回归中，诱导性缺血和晚期钆增强是 MACE 发生率较高的独立预测因子（风险比，2.79 [95% CI，2.16-3.60]；P <0.001 和风险比，1.41 [95% CI，1.04- 1.90], P = 0.032;）。结论：有经皮冠状动脉介入治疗史的患者，应激性CMR评估的诱导性缺血和迟发钆增强与MACE独立相关。