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Stress CMR in patients with obesity: insights from the Stress CMR Perfusion Imaging in the United States (SPINS) registry.

Publication ,  Journal Article
Ge, Y; Steel, K; Antiochos, P; Bingham, S; Abdullah, S; Mikolich, JR; Arai, AE; Bandettini, WP; Shanbhag, SM; Patel, AR; Farzaneh-Far, A ...
Published in: Eur Heart J Cardiovasc Imaging
April 28, 2021

AIMS: Non-invasive assessment and risk stratification of coronary artery disease in patients with large body habitus is challenging. We aim to examine whether body mass index (BMI) modifies the prognostic value and diagnostic utility of stress cardiac magnetic resonance imaging (CMR) in a multicentre registry. METHODS AND RESULTS: The SPINS Registry enrolled consecutive intermediate-risk patients who presented with a clinical indication for stress CMR in the USA between 2008 and 2013. Baseline demographic data including BMI, CMR indices, and ratings of study quality were collected. Primary outcome was defined by a composite of cardiovascular death and non-fatal myocardial infarction. Of the 2345 patients with available BMI included in the SPINS cohort, 1177 (50%) met criteria for obesity (BMI ≥ 30) with 531 (23%) at or above Class 2 obesity (BMI ≥ 35). In all BMI categories, >95% of studies were of diagnostic quality for cine, perfusion, and late gadolinium enhancement (LGE) sequences. At a median follow-up of 5.4 years, those without ischaemia and LGE experienced a low annual rate of hard events (<1%), across all BMI strata. In patients with obesity, both ischaemia [hazard ratio (HR): 2.14; 95% confidence interval (CI): 1.30-3.50; P = 0.003] and LGE (HR: 3.09; 95% CI: 1.83-5.22; P < 0.001) maintained strong adjusted association with the primary outcome in a multivariable Cox regression model. Downstream referral rates to coronary angiography, revascularization, and cost of care spent on ischaemia testing did not significantly differ within the BMI categories. CONCLUSION: In this large multicentre registry, elevated BMI did not negatively impact the diagnostic quality and the effectiveness of risk stratification of patients referred for stress CMR.

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Published In

Eur Heart J Cardiovasc Imaging

DOI

EISSN

2047-2412

Publication Date

April 28, 2021

Volume

22

Issue

5

Start / End Page

518 / 527

Location

England

Related Subject Headings

  • United States
  • Registries
  • Prognosis
  • Predictive Value of Tests
  • Perfusion Imaging
  • Obesity
  • Magnetic Resonance Imaging, Cine
  • Magnetic Resonance Imaging
  • Humans
  • Gadolinium
 

Citation

APA
Chicago
ICMJE
MLA
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Ge, Y., Steel, K., Antiochos, P., Bingham, S., Abdullah, S., Mikolich, J. R., … Kwong, R. Y. (2021). Stress CMR in patients with obesity: insights from the Stress CMR Perfusion Imaging in the United States (SPINS) registry. Eur Heart J Cardiovasc Imaging, 22(5), 518–527. https://doi.org/10.1093/ehjci/jeaa281
Ge, Yin, Kevin Steel, Panagiotis Antiochos, Scott Bingham, Shuaib Abdullah, J Ronald Mikolich, Andrew E. Arai, et al. “Stress CMR in patients with obesity: insights from the Stress CMR Perfusion Imaging in the United States (SPINS) registry.Eur Heart J Cardiovasc Imaging 22, no. 5 (April 28, 2021): 518–27. https://doi.org/10.1093/ehjci/jeaa281.
Ge Y, Steel K, Antiochos P, Bingham S, Abdullah S, Mikolich JR, et al. Stress CMR in patients with obesity: insights from the Stress CMR Perfusion Imaging in the United States (SPINS) registry. Eur Heart J Cardiovasc Imaging. 2021 Apr 28;22(5):518–27.
Ge, Yin, et al. “Stress CMR in patients with obesity: insights from the Stress CMR Perfusion Imaging in the United States (SPINS) registry.Eur Heart J Cardiovasc Imaging, vol. 22, no. 5, Apr. 2021, pp. 518–27. Pubmed, doi:10.1093/ehjci/jeaa281.
Ge Y, Steel K, Antiochos P, Bingham S, Abdullah S, Mikolich JR, Arai AE, Bandettini WP, Shanbhag SM, Patel AR, Farzaneh-Far A, Heitner JF, Shenoy C, Leung SW, Gonzalez JA, Shah DJ, Raman SV, Nawaz H, Ferrari VA, Schulz-Menger J, Stuber M, Simonetti OP, Kwong RY. Stress CMR in patients with obesity: insights from the Stress CMR Perfusion Imaging in the United States (SPINS) registry. Eur Heart J Cardiovasc Imaging. 2021 Apr 28;22(5):518–527.
Journal cover image

Published In

Eur Heart J Cardiovasc Imaging

DOI

EISSN

2047-2412

Publication Date

April 28, 2021

Volume

22

Issue

5

Start / End Page

518 / 527

Location

England

Related Subject Headings

  • United States
  • Registries
  • Prognosis
  • Predictive Value of Tests
  • Perfusion Imaging
  • Obesity
  • Magnetic Resonance Imaging, Cine
  • Magnetic Resonance Imaging
  • Humans
  • Gadolinium