Authors
Eike Nagel, John P Greenwood, Gerry P McCann, Nuno Bettencourt, Ajay M Shah, Shazia T Hussain, Divaka Perera, Sven Plein, Chiara Bucciarelli-Ducci, Matthias Paul, Mark A Westwood, Michael Marber, Wolf-Stefan Richter, Valentina O Puntmann, Carsten Schwenke, Jeanette Schulz-Menger, Rajiv Das, Joyce Wong, Derek J Hausenloy, Henning Steen, Colin Berry
Publication date
2019/6/20
Journal
New England Journal of Medicine
Volume
380
Issue
25
Pages
2418-2428
Publisher
Massachusetts Medical Society
Description
Background
In patients with stable angina, two strategies are often used to guide revascularization: one involves myocardial-perfusion cardiovascular magnetic resonance imaging (MRI), and the other involves invasive angiography and measurement of fractional flow reserve (FFR). Whether a cardiovascular MRI–based strategy is noninferior to an FFR-based strategy with respect to major adverse cardiac events has not been established.
Methods
We performed an unblinded, multicenter, clinical-effectiveness trial by randomly assigning 918 patients with typical angina and either two or more cardiovascular risk factors or a positive exercise treadmill test to a cardiovascular MRI–based strategy or an FFR-based strategy. Revascularization was recommended for patients in the cardiovascular-MRI group with ischemia in at least 6% of the myocardium or in the FFR group with an FFR of 0.8 or less. The composite …
Scholar articles
E Nagel, JP Greenwood, GP McCann, N Bettencourt… - New England Journal of Medicine, 2019