SP-CMR ICA ≥70% DS 51 25 14 219 SP-CMR or LGE 53 28 12 216 Motwani et Level II N=100/111 patients with SP-CMR + LGE ICA ≥50% DS 30% 25 19 5 51 CMR could not be completed: al. () suspected CAD 8/111 Low risk of UK bias (3 patients were claustrophobic, 2 declined and 3 encountered technical problems). ICA was cancelled for clinical reasons unrelated to the CMR findings: 3/111 Pereira et al. Level II N=80/121 patients with SP-CMR + LGE ICA ≥90% DS 46% 30 18 7 25 CMR not performed: 13/121 () suspected CAD or FFR ≤0.80 (4 due to claustrophobia) Low risk of 38% 15 2 4 29 Portugal bias N=50 patients with an ICA not performed: 4/121 intermediate PTP for (refusal) CAD Treadmill exercise tolerance testing not performed: 24/121 Interobserver agreement for CMR: kappa = 0.56. Both observers agreed on the exact pattern of perfusion in 57 (71.2%) scans Klem et al. () Level II N=92/100 patients with SP-CMR ICA ≥70% DS 40% 31 23 6 32 Incomplete CMR test: 8/100: suspected CAD scanner/operator error: 3/100 USA Low risk of LGE viability 40% 18 1 19 54 patient too large: 1/100 bias adenosine-induced dyspnoea: SP-CMR + LGE 40% 33 7 4 48 1/100 SP-CMR ICA ≥50% DS 48% 36 18 8 30 non-CMR related issues: 3/100 LGE viability 18 1 26 47 Interobserver variability was not tested (readers not SP-CMR + LGE 34 6 10 42 independent), but only 8% of
SP-CMR SP-CMR or LGE ICA ≥70% DS 51 53 25 28 14 12 219 216 Motwani et al. () UK Level II Low risk of bias N=100/111 patients with suspected CAD SP-CMR + LGE ICA ≥50% DS 30% 25 19 5 51 CMR could not be completed: 8/111 (3 patients were claustrophobic, 2 declined and 3 encountered technical problems). ICA was cancelled for clinical reasons unrelated to the CMR findings: 3/111 Pereira et al. () Portugal Level II Low risk of bias N=80/121 patients with suspected CAD N=50 patients with an intermediate PTP for CAD SP-CMR + LGE ICA ≥90% DS or FFR ≤0.80 46% 38% 30 15 18 2 7 4 25 29 CMR not performed: 13/121 (4 due to claustrophobia) ICA not performed: 4/121 (refusal) Treadmill exercise tolerance testing not performed: 24/121 Interobserver agreement for CMR: kappa = 0.56. Both observers agreed on the exact pattern of perfusion in 57 (71.2%) scans Klem et al. () USA Level II Low risk of bias N=92/100 patients with suspected CAD SP-CMR LGE viability SP-CMR + LGE SP-CMR LGE viability SP-CMR + LGE ICA ≥70% DS ICA ≥50% DS 40% 40% 40% 48% 31 18 33 36 18 34 23 1 7 18 1 6 6 19 4 8 26 10 32 54 48 30 47 42 Incomplete CMR test: 8/100: scanner/operator error: 3/100 patient too large: 1/100 adenosine-induced dyspnoea: 1/100 non-CMR related issues: 3/100 Interobserver variability was not tested (readers not independent), but only 8% of