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.