| Prognosis of negative adenosine stress magnetic resonance in patients presenting to an emergency department with chest pain. | |
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MedLine Citation:
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PMID: 16580532 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: This study was designed to determine the diagnostic value of adenosine cardiac magnetic resonance (CMR) in troponin-negative patients with chest pain. BACKGROUND: We hypothesized that adenosine CMR could determine which troponin-negative patients with chest pain in an emergency department have coronary artery disease (CAD) or future adverse cardiac events. METHODS: Adenosine stress CMR was performed on 135 patients who presented to the emergency department with chest pain and had acute myocardial infarction (MI) excluded by troponin-I. The main study outcome was detecting any evidence of significant CAD. Patients were contacted at one year to determine the incidence of significant CAD defined as coronary artery stenosis >50% on angiography, abnormal correlative stress test, new MI, or death. RESULTS: Adenosine perfusion abnormalities had 100% sensitivity and 93% specificity as the single most accurate component of the CMR examination. Both cardiac risk factors and CMR were significant in Kaplan-Meier analysis (log-rank test, p = 0.0006 and p < 0.0001, respectively). However, an abnormal CMR added significant prognostic value in predicting future diagnosis of CAD, MI, or death over clinical risk factors. In receiver operator curve analysis, adenosine CMR was a more accurate predictor than cardiac risk factors (p < 0.002). CONCLUSIONS: In patients with chest pain who had MI excluded by troponin-I and non-diagnostic electrocardiograms, an adenosine CMR examination predicted with high sensitivity and specificity which patients had significant CAD during one-year follow-up. Furthermore, no patients with a normal adenosine CMR study had a subsequent diagnosis of CAD or an adverse outcome. |
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Authors:
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W Patricia Ingkanisorn; Raymond Y Kwong; Nicole S Bohme; Nancy L Geller; Kenneth L Rhoads; Christopher K Dyke; D Ian Paterson; Mushabbar A Syed; Anthony H Aletras; Andrew E Arai |
Publication Detail:
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Type: Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural Date: 2006-03-20 |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 47 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2006 Apr |
Date Detail:
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Created Date: 2006-04-03 Completed Date: 2006-05-26 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1427-32 Citation Subset: AIM; IM |
Affiliation:
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Laboratory of Cardiac Energetics, National Heart, Lung, and Blood Institute, National Institutes of Health, and Suburban Hospital, Bethesda, Maryland 20892-1061, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenosine
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diagnostic use* Adult Aged Chest Pain / complications*, diagnosis*, mortality Coronary Artery Disease / etiology* Emergency Medical Services* Exercise Test* Female Follow-Up Studies Humans Magnetic Resonance Angiography* Male Middle Aged Predictive Value of Tests Prognosis Proportional Hazards Models Prospective Studies Sensitivity and Specificity Survival Analysis |
| Chemical | |
Reg. No./Substance:
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58-61-7/Adenosine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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