Document Detail


Prognostic value of late gadolinium enhancement in hypertensive patients with known or suspected coronary artery disease.
MedLine Citation:
PMID:  20049536     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine the prognosis of a myocardial scar assessed by a late gadolinium enhancement (LGE) technique of cardiac magnetic resonance (CMR) in hypertensive patients with known or suspected coronary artery disease (CAD). Patients with systemic hypertension with known or suspected CAD without a clinical history of myocardial infarction were enrolled. All patients underwent CMR for assessment of cardiac function and LGE. Prognostic data was determined by the occurrence of a hard cardiac endpoint, defined as cardiac death or a non-fatal myocardial infarction, or major adverse cardiac events (MACEs), defined as cardiac death, a non-fatal myocardial infarction, or hospitalization due to heart failure, unstable angina, or life-threatening ventricular arrhythmia. A total of 1,644 patients were enrolled; 48% were males and the mean age was 65 +/- 11 years. The average follow-up time was 863 +/- 559 days. Four hundred fifty-three (28%) patients had LGE. LGE was the strongest and most independent predictor for hard events and MACEs with hazard ratios of 4.77 and 3.38, respectively. Other independent predictors of hard events and MACEs were left ventricular ejection fraction and mass, the use of a beta-blocker, and a history of heart failure. The risk of cardiac events increased as the extent of LGE increased; the hazard ratio was 12.74 for hard events for those with a LGE >20% of the myocardium. LGE is the most important and independent predictor for cardiac events in hypertensive patients with known or suspected CAD.
Authors:
Rungroj Krittayaphong; Thananya Boonyasirinant; Vithaya Chaithiraphan; Adisak Maneesai; Pairash Saiviroonporn; Supaporn Nakyen; Prajak Thanapiboonpol; Ahthit Yindeengam; Suthipol Udompanturak
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Publication Detail:
Type:  Journal Article     Date:  2010-01-05
Journal Detail:
Title:  The international journal of cardiovascular imaging     Volume:  26 Suppl 1     ISSN:  1875-8312     ISO Abbreviation:  Int J Cardiovasc Imaging     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-05     Completed Date:  2010-05-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100969716     Medline TA:  Int J Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  123-31     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand. sirkt@mahidol.ac.th
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MeSH Terms
Descriptor/Qualifier:
Aged
Chi-Square Distribution
Contrast Media / diagnostic use*
Coronary Angiography
Coronary Artery Disease / etiology,  mortality,  pathology*
Female
Gadolinium / diagnostic use*
Heart Diseases / etiology*,  mortality,  pathology
Humans
Hypertension / complications*,  mortality,  pathology
Kaplan-Meiers Estimate
Magnetic Resonance Imaging*
Male
Middle Aged
Myocardium / pathology*
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Risk Assessment
Risk Factors
Time Factors
Chemical
Reg. No./Substance:
0/Contrast Media; 7440-54-2/Gadolinium

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