Prognosis in patients with normal cardiac perfusion scans

Introduction

Cardiac magnetic perfusion (CMR) scans are being increasingly used for both diagnostic and prognostic purposes in patients with suspected coronary artery disease. However the validity of this assumption in a clinical setting is not well documented.

Purpose

The aim of this study is to determine the short term outcome in patients referred for non invasive stress imaging by stress cardiac MRI (CMR) who had normal stress perfusion scans.

Methods

We identified 100 consecutive patients who underwent stress perfusion cardiac magnetic resonance scans between March 2008 and November 2008 and were reported as having normal perfusion scans. Patients were contacted via telephone to determine the endpoints of an adverse cardiac event identified as a composite of death from coronary heart disease or hospital admission with an acute coronary syndrome. Case notes were checked to confirm the endpoint when it occurred.

Results

Over a median follow up of 1.07 years (IQR 0.89-1.26), of the 100 patients identified with a normal perfusion scan, none had died and only one was admitted with an acute coronary syndrome.

Conclusion

Clinically indicated CMR perfusion scans can safely identify patients at risk of death from coronary heart disease or acute coronary syndrome. Further studies are needed to determine the long term outcome in this group of patients.