Abstract:
BACKGROUND:Gadolinium-based contrast agents were not approved in the United States for detecting coronary artery disease (CAD) prior to the current studies. OBJECTIVES:The purpose of this study was to determine the sensitivity and specificity of gadobutrol for detection of CAD by assessing myocardial perfusion and late gadolinium enhancement (LGE) imaging. METHODS:Two international, single-vendor, phase 3 clinical trials of near identical design, "GadaCAD1" and "GadaCAD2," were performed. Cardiovascular magnetic resonance (CMR) included gadobutrol-enhanced first-pass vasodilator stress and rest perfusion followed by LGE imaging. CAD was defined by quantitative coronary angiography (QCA) but computed tomography coronary angiography could exclude significant CAD. RESULTS:Because the design and results for GadaCAD1 (n = 376) and GadaCAD2 (n = 388) were very similar, results were summarized as a fixed-effect meta-analysis (n = 764). The prevalence of CAD was 27.8% defined by a ≥70% QCA stenosis. For detection of a ≥70% QCA stenosis, the sensitivity of CMR was 78.9%, specificity was 86.8%, and area under the curve was 0.871. The sensitivity and specificity for multivessel CAD was 87.4% and 73.0%. For detection of a 50% QCA stenosis, sensitivity was 64.6% and specificity was 86.6%. The optimal threshold for detecting CAD was a ≥67% QCA stenosis in GadaCAD1 and ≥63% QCA stenosis in GadaCAD2. CONCLUSIONS:Vasodilator stress and rest myocardial perfusion CMR and LGE imaging had high diagnostic accuracy for CAD in 2 phase 3 clinical trials. These findings supported the U.S. Food and Drug Administration approval of gadobutrol-enhanced CMR (0.1 mmol/kg) to assess myocardial perfusion and LGE in adult patients with known or suspected CAD.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Arai AE,Schulz-Menger J,Berman D,Mahrholdt H,Han Y,Bandettini WP,Gutberlet M,Abraham A,Woodard PK,Selvanayagam JB,McCann GP,Hamilton-Craig C,Schoepf UJ,San Tan R,Kramer CM,Friedrich MG,Haverstock D,Liu Z,Brueggenwerthdoi
10.1016/j.jacc.2020.07.060subject
Has Abstractpub_date
2020-09-29 00:00:00pages
1536-1547issue
13eissn
0735-1097issn
1558-3597pii
S0735-1097(20)36234-3journal_volume
76pub_type
杂志文章abstract:OBJECTIVES:The goal of this study was to determine the predictive value of pregnancy-associated plasma protein-A (PAPP-A) in patients with acute coronary syndromes (ACS). BACKGROUND:Pregnancy-associated plasma protein-A is a zinc-binding matrix metalloproteinase abundantly expressed in eroded and ruptured plaques and ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2004.09.060
更新日期:2005-01-18 00:00:00
abstract:OBJECTIVES:We report the occurrence of cardiac events during long-term follow-up in patients with hypertrophic cardiomyopathy (HCM) after cardioverter-defibrillator implantation. BACKGROUND:The identification of patients at high risk for sudden death and the prevention of recurrence of sudden death in HCM represents a...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(98)00037-0
更新日期:1998-04-01 00:00:00
abstract::This study describes the long-term outcome of 33 patients with hypertrophic cardiomyopathy who experienced a cardiac arrest but were successfully resuscitated. Cardiac arrest occurred at ages 9 to 62 years (mean 32); five patients survived multiple (two or three) arrests. A variety of treatments were administered; 18 ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(89)90302-1
更新日期:1989-05-01 00:00:00
abstract:OBJECTIVES:We sought to assess whether there were differences, relative to racial ethnicity, in coronary revascularization recommendations made by a panel that had no knowledge of the patients' ethnicity. BACKGROUND:Coronary revascularization is employed less frequently in African American than in white patients. It i...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/s0735-1097(01)01418-8
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to assess the hemorrhagic risk associated with fibrin-specific thrombolytic therapy and invasive procedures with acute myocardial infarction. BACKGROUND:Successful coronary artery reperfusion has important prognostic implications. Because immediate coronary angiography is the only ...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/0735-1097(93)90090-n
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:A leadless cardiac pacemaker (LCP) system was recently introduced to overcome lead-related complications of conventional pacing systems. To date, long-term results of an LCP system are unknown. OBJECTIVES:The aim of this study was to assess the complication incidence, electrical performance, and rate respon...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jacc.2015.02.022
更新日期:2015-04-21 00:00:00
abstract:OBJECTIVES:The goal of this study was to compare myocardial perfusion reserve (MPR) before and after long-term treatment with lisinopril and losartan in patients with hypertension and left ventricular hypertrophy (LVH). BACKGROUND:Studies have suggested that treatment with angiotensin-converting enzyme inhibitors (ACE...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2002-08-21 00:00:00
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doi:10.1016/s0735-1097(99)00365-4
更新日期:1999-11-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2000-11-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2001-03-15 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(10)80143-3
更新日期:1991-05-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(87)80298-x
更新日期:1987-05-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)90169-4
更新日期:1994-12-01 00:00:00
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pub_type: 杂志文章,多中心研究
doi:10.1016/j.jacc.2020.06.017
更新日期:2020-08-04 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2007.10.048
更新日期:2008-03-04 00:00:00
abstract:OBJECTIVES:The goal of this study was to examine the association between paraoxonase-1 (PON1) activity and concentration and the severity and extent of coronary artery disease (CAD). BACKGROUND:Paraoxonase-1, a high-density lipoprotein-associated enzyme, is proposed to have an antiatherogenic effect by protecting low-...
journal_title:Journal of the American College of Cardiology
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doi:10.1016/j.jacc.2006.01.074
更新日期:2006-06-20 00:00:00
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更新日期:2017-02-28 00:00:00
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更新日期:2005-10-18 00:00:00
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更新日期:2009-08-11 00:00:00
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更新日期:2018-03-06 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1992-02-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(89)90352-5
更新日期:1989-06-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:1991-09-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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更新日期:2004-07-21 00:00:00
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更新日期:1997-03-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
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更新日期:2004-04-07 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(96)00159-3
更新日期:1996-08-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(89)90268-4
更新日期:1989-04-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(96)00027-7
更新日期:1996-05-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(87)80123-7
更新日期:1987-12-01 00:00:00