Prognostic stratification and predictive performance of stress CMR in a Secondary Prevention Cohort: Insights from the Nancy Ischemia Registry - 08/01/26
, S. Tissier 2, C. Balaj 2, M. Lafitte 2, M. Amor 1, C. Breton 1, M. Angioi 1, N. Benzaghou 1, K. Belhadj 1, G. Farah 1, C.-H. Maigrat 1, A. Olivier 1, J. Schwartz 1, J.-P. Simon 1, J. Lemoine 1Résumé |
Introduction |
The long-term prognostic value of myocardial revascularization in patients with established coronary artery disease remains controversial. Real-world evaluation of ischemia detection and subsequent outcomes in secondary prevention is essential.
Objective |
Nancy Ischemia Registry aimed to assess the prognostic role of stress cardiac magnetic resonance (CMR) imaging in patients undergoing secondary prevention after prior revascularization.
Method |
We analysed prospectively 562 patients (mean age 64 ± 8 years, 83% male) from the Nancy Ischemia Registry, all of whom underwent stress cardiac magnetic resonance imaging (CMR) between 2021 and 2024, approximately 9–12 months after a prior myocardial revascularization procedure. Stress-CMR was used to detect residual myocardial ischemia as part of routine secondary prevention follow-up.
Results |
At baseline, 39% of patients had residual ischemia and 35% showed LGE. During a 499-day median follow-up, stress-CMR ischemia predicted repeat revascularization with 45% PPV, 96% NPV, 87% sensitivity, and 73% specificity. LGE+ patients had a higher revascularization rate (16% vs. 2%, OR: 11.86, P < 0.00001), but LGE alone had limited sensitivity (15%) despite high specificity (98%). Six deaths occurred during follow-up.
Conclusion |
In patients undergoing secondary prevention, both stress-induced ischemia and LGE on stress-CMR are valuable prognostic markers. Absence of ischemia predicts freedom from future revascularization with 96% NPV, while LGE positivity predicts recurrence of revascularization with 98% specificity, supporting their use in long-term clinical decision-making.
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Vol 119 - N° 1S
P. S23-S24 - janvier 2026 Retour au numéro
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