1062 DIAGNOSTIC AND PROGNOSTIC VALUE OF STRESS CMR IMAGING TO EVALUATE STABLE CHEST PAIN: A TWENTY-YEAR META-ANALYSIS

Abstract Background Assessment of inducible ischemia with stress cardiovascular magnetic resonance (CMR) is recommended in patients chest pain and intermediate or high pre-test probability coronary artery disease (CAD). We aimed to provide a contemporary quantitative data synthesis on diagnostic accuracy prognostic value CMR stable syndromes. Methods performed systematic review meta-analysis studies published over the last twenty years (PROSPERO: CRD42022299275). measured pooled indicators, including odds ratio (DOR), sensitivity, specificity, area under curve (AUC), summary effect size ratios (ORs) cumulative annualized event rates (AERs) for all-cause death, death major adverse cardiac events (MACE). Results identified 33 pooling 7,815 individuals (mean age, 62 years, 62% males) 31 67,080 years; 57% males; mean follow-up 3.5 total 381,357 person-years). Stress yielded DOR 26.4 (95%CI:10.6-65.9), sensitivity 81% (95%CI:68-89%), specificity 86% (95%CI:75-93%), an AUC 0.84 (95%CI:0.77-0.89) detection functionally obstructive CAD fractional flow reserve as reference test. In subgroup analysis, 3 Tesla imaging higher achieving 33.2. Presence stress-inducible was associated mortality (OR:2.0; 95%CI:1.7-2.3), (OR:6.4; 95%CI:4.5-9.1), increased risk MACE (OR:5.3; 95%CI:4.0-7.0). AERs were <1% without ischemia. Conclusions yields delivers robust prognostication known suspected CAD, particularly imaging. While portends excess MACE, negative indicates very low future events, warranty period at least years.