Male: 65% To evaluate indications, image scans (62.6%) to results of CMR quality, safety and impact on patient Ethnicity: NR Adenosine: 8,018/27,395 scans management of clinical routine (29.3%) CMR in a multi-national European setting Dobutamine: 2,219/27,395 scans (8.1%) Protocol for CMR: In accordance with standardized stress CMR protocols Follow-up: Mean (IQR): 400 days (367–419); follow-up rate 90% Schonenberger Level II: N=111 patients with Inclusion criteria: Setting: NR CTCA, ICA Patient acceptability and et al. () study suspected CAD preference No contraindications to CMR MRI machine: 1.5-T scanner with Germany Quality: Mean age: phased-array coil Exclusion criteria: 63 ± 8 years Reporting 9/10 Stress agent: NR Patients with contraindications (e.g. Male: 75% External validity claustrophobia, implanted Protocol for CMR: Unclear 1/3 Ethnicity: NR pacemakers) Follow-up: NR Bias 6/7 Objective: Confounding 5/6 To compare the patient acceptability of CMR, CTCA and Total 21/26 ICA Low risk of bias Shah et al. () Level IV: CS N=815 patients Inclusion criteria: Setting: General and specialist NA Change in risk referred for cardiology services within hospital classification with addition USA Quality: 10/12 Patients >18 years of age with assessment of of inducible ischaemia to clinical suspicion of myocardial MRI machine: myocardial the clinical risk model for Low risk of bias ischaemia 1.5-T scanner for 381 patients (47%) ischaemia, of whom patients with and without enrolled pre-2006 792 were included MACE Exclusion criteria: in the final analysis; 3.0-T scanner used post-2006 for 434 Absolute contraindication to CMR Overall risk 273/792 (34%) had patients (53%) reclassification by (e.g. metallic hazards, pregnancy, previous CAD addition of inducible severe renal dysfunction) or Stress agent: Adenosine (n=396); Mean age: ischaemia to clinical risk contraindications to vasodilator regadenoson (n=389); dipyridamole
Male: 65% Ethnicity: NR To evaluate indications, image quality, safety and impact on patient management of clinical routine CMR in a multi-national European setting scans (62.6%) Adenosine: 8,018/27,395 scans (29.3%) Dobutamine: 2,219/27,395 scans (8.1%) Protocol for CMR: In accordance with standardized stress CMR protocols Follow-up: Mean (IQR): 400 days (367–419); follow-up rate 90% to results of CMR Schonenberger et al. () Germany Level II: study Quality: Reporting 9/10 External validity 1/3 Bias 6/7 Confounding 5/6 Total 21/26 Low risk of bias N=111 patients with suspected CAD Mean age: 63 ± 8 years Male: 75% Ethnicity: NR Inclusion criteria: No contraindications to CMR Exclusion criteria: Patients with contraindications (e.g. claustrophobia, implanted pacemakers) Objective: To compare the patient acceptability of CMR, CTCA and ICA Setting: NR MRI machine: 1.5-T scanner with phased-array coil Stress agent: NR Protocol for CMR: Unclear Follow-up: NR CTCA, ICA Patient acceptability and preference Shah et al. () USA Level IV: CS Quality: 10/12 Low risk of bias N=815 patients referred for assessment of myocardial ischaemia, of whom 792 were included in the final analysis; 273/792 (34%) had previous CAD Mean age: Inclusion criteria: Patients >18 years of age with clinical suspicion of myocardial ischaemia Exclusion criteria: Absolute contraindication to CMR (e.g. metallic hazards, pregnancy, severe renal dysfunction) or contraindications to vasodilator Setting: General and specialist cardiology services within hospital MRI machine: 1.5-T scanner for 381 patients (47%) enrolled pre-2006 3.0-T scanner used post-2006 for 434 patients (53%) Stress agent: Adenosine (n=396); regadenoson (n=389); dipyridamole NA Change in risk classification with addition of inducible ischaemia to the clinical risk model for patients with and without MACE Overall risk reclassification by addition of inducible ischaemia to clinical risk