Derivation and validation of a prognostic prediction rule from clinical and stress CMR data characterizes cardiac progno
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ORAL PRESENTATION
Open Access
Derivation and validation of a prognostic prediction rule from clinical and stress CMR data characterizes cardiac prognostication in patients with suspected myocardial ischemia Otavio R Coelho-Filho*, François-Pierre Mongeon, Michael Jerosch-Herold, Raymond Y Kwong From 2011 SCMR/Euro CMR Joint Scientific Sessions Nice, France. 3-6 February 2011 Objectives We sought to derive and validate a parsimonious predictive rule incorporating clinical and stress CMR data to characterize major adverse cardiac events (MACE) in patients with suspected ischemia. Methods/results Out of 736 patients referred for assessment of suspected ischemia by vasodilator stress perfusion CMR, 25 (3%) were excluded due to images of insufficient quality. The remaining 711 patients (297 females, mean age 56±15 years) were followed for cardiac events (MACE) that occurred within the first 3 years after CMR (100% complete follow-up; median of 21.4 months, range 2.5 months to 8.2 years). We randomized patients in this clinical cohort 1:1 into a training set (SET Training , n=356) and a testing set (SETTesting, n=355). Forty-six (6.5%) patients experienced MACE: 24 (7%) in the SETTraining and 22 (6%) in the SET Testing . A parsimonious prediction rule was built by stepwise regression in the SET Training , considering all clinical, ECG, and CMR parameters using P10%). The utility of the model was first determined by comparing the predicted and observed numbers of MACE in each risk category in the SETTesting (Figure-1).
Table 1 Best overall Model for MACE (SETTRAINING, n=356, MACE at 3 years=23 Variable
Estimate LRΧ2 OR
P-Value Final Model
ISCH-SCORE, per unit 0.2104
46.3
1.234
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