ACC.17 Late Breaking Clinical Trials| MR-INFORM: Stress Perfusion Imaging to Guide the Management of Stable CAD Patients
MR-INFORM trial results released: MR perfusion imaging could replace invasive procedures in patients with stable angina
Prof. Eike Nagel, director of the Institute of Experimental and Translational Cardiovascular Imaging at the Goethe University Frankfurt presented the key findings of the MR-INFORM study at the American College for Cardiology Scientific Sessions in Washington, DC, US as a late breaking clinical trial. The MR-INFORM study investigated the clinical effectiveness of non-invasive magnetic resonance perfusion measurements in comparison to invasive coronary angiography supported by pressure measurements in the coronary arteries (fractional flow reserve, FFR), in patients with stable angina. The main finding is that non-invasive magnetic resonance perfusion imaging can guide patient management as safely as the currently used invasive coronary angiography supported by FFR in a population at high risk for cardiovascular events.
MR-perfusion imaging is a non-invasive test based on magnetic resonance imaging, which measures the blood flow in the heart directly. It is fast, does not require ionizing radiation and has a favourable accuracy for the non-invasive diagnosis of prognostically relevant coronary artery disease. Invasive coronary angiography is the current standard of care and adding FFR measurements has shown to improve outcome.
The MR-INFORM investigators randomized 918 patients with effort induced chest pain into either invasive testing with angiography and FFR measurements or into magnetic resonance perfusion imaging. The subsequent management strategy was then guided by the result of the respective test. Patients were only revascularized if the first line test was positive. All patients were followed up for one year and any major event (death, myocardial infarction, re-revascularization of the index vessel) was recorded. In both groups patients did well with a very low event rate (3.9% in the angiography guided group and 3.33% in the MR perfusion guided group). Both tests performed identically, demonstrating that patients can be safely guided by magnetic resonance perfusion imaging as the first line technique.
Dr. Valentina Puntmann received the 2016 Young Author Achievement Award for her contributions to JACC Cardiovascular Imaging, most notably her manuscript "T1-mapping and outcome in nonischaemic cardiomyopathy: all-cause mortality and heart failure" http://www.imaging.onlinejacc.org/content/9/1/40. In March 2017 the paper had been cited 32 times according to google scholar.
Prof Dr Eike Nagel
Director of the Institute for Experimental and Translational Cardiovascular Imaging, University Hospital Frankfurt