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MR-IMPACT II: Magnetic Resonance Imaging for Myocardial Perfusion Assessment in Coronary artery disease Trial: perfusion-cardiac magnetic resonance vs. single-photon emission computed tomography for the detection of coronary artery disease: a comparative multicentre, multivendor trial
Open accessAbstract
AIMS: Perfusion-cardiac magnetic resonance (CMR) has emerged as a potential alternative to single-photon emission computed tomography (SPECT) to assess myocardial ischaemia non-invasively. The goal was to compare the diagnostic performance of perfusion-CMR and SPECT for the detection of coronary artery disease (CAD) using conventional X-ray coronary angiography (CXA) as the reference standard. METHODS AND RESULTS: In this multivendor trial, 533 patients, eligible for CXA or SPECT, were enrolled in 33 centres (USA and Europe) with 515 patients receiving MR contrast medium. Single-photon emission computed tomography and CXA were performed within 4 weeks before or after CMR in all patients. The prevalence of CAD in the sample was 49%. Drop-out rates for CMR and SPECT were 5.6 and 3.7%, respectively (P = 0.21). The primary endpoint was non-inferiority of CMR vs. SPECT for both sensitivity and specificity for the detection of CAD. Readers were blinded vs. clinical data, CXA, and imaging results. As a secondary endpoint, the safety profile of the CMR examination was evaluated. For CMR and SPECT, the sensitivity scores were 0.67 and 0.59, respectively, with the lower confidence level for the difference of +0.02, indicating superiority of CMR over SPECT. The specificity scores for CMR and SPECT were 0.61 and 0.72, respectively (lower confidence level for the difference: -0.17), indicating inferiority of CMR vs. SPECT. No severe adverse events occurred in the 515 patients. CONCLUSION: In this large multicentre, multivendor study, the sensitivity of perfusion-CMR to detect CAD was superior to SPECT, while its specificity was inferior to SPECT. Cardiac magnetic resonance is a safe alternative to SPECT to detect perfusion deficits in CAD.
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WRITING GROUP MEMBERS, Lloyd-Jones, D., Adams, R., Carnethon, M., De Simone, G., Ferguson, T. B., Flegal, K., Ford, E., Furie, K., Go, A., et al. (2009) · Circulation · doi:10.1161/circulationaha.108.191261 · Cited by 3,140
Reporting of Noninferiority and Equivalence Randomized Trials: An Extension of the CONSORT Statement
Piaggio, G., Elbourne, D. R., Altman, D. G., Pocock, S. J., Evans, S. J. W., & CONSORT Group, F. T. (2006) · JAMA · doi:10.1001/jama.295.10.1152 · Cited by 1,153
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2013 ESC guidelines on the management of stable coronary artery disease
Task Force Members, Montalescot, G., Sechtem, U., Achenbach, S., Andreotti, F., Arden, C., Budaj, A., Bugiardini, R., Crea, F., Cuisset, T., et al. (2013) · European Heart Journal · doi:10.1093/eurheartj/eht296 · Cited by 4,510
Virani, S. S., Newby, L. K., Arnold, S. V., Bittner, V., Brewer, L. C., Demeter, S. H., Dixon, D. L., Fearon, W. F., Hess, B., Johnson, H. M., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001168 · Cited by 1,598
Virani, S. S., Newby, L. K., Arnold, S. V., Bittner, V., Brewer, L. C., Demeter, S. H., Dixon, D. L., Fearon, W. F., Hess, B., Johnson, H. M., et al. (2023) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.04.003 · Cited by 596
Metadata
- Authors
- Schwitter, J., Wacker, C. M., Wilke, N., Al-Saadi, N., Sauer, E., Huettle, K., Schönberg, S. O., Luchner, A., Strohm, O., Ahlstrom, H., Dill, T., Hoebel, N., Simor, T., & for the MR-IMPACT Investigators
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-03-04
- Volume
- 34
- Issue
- 10
- Pages
- 775-781
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W2129884887
- Cited by
- 456
- References
- 2
- FWCI
- 34.49
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Schwitter, J., Wacker, C. M., Wilke, N., Al-Saadi, N., Sauer, E., Huettle, K., Schönberg, S. O., Luchner, A., Strohm, O., Ahlstrom, H., Dill, T., Hoebel, N., Simor, T., & for the MR-IMPACT Investigators. (2013). MR-IMPACT II: Magnetic Resonance Imaging for Myocardial Perfusion Assessment in Coronary artery disease Trial: perfusion-cardiac magnetic resonance vs. single-photon emission computed tomography for the detection of coronary artery disease: a comparative multicentre, multivendor trial. European Heart Journal. https://doi.org/10.1093/eurheartj/ehs022
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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