Long-Term Warranty Period of Stress CMR and SPECT in Stable Angina: Implications for Repeat Testing.

Authors

Giandomenico Bisaccia, Peter P Swoboda, John F Younger, Neil Maredia, Chiara Bucciarelli-Ducci, Sven Plein, John P Greenwood

Published in

JACC. Cardiovascular imaging. Sep 15, 2026. Epub Sep 15, 2026.

Abstract

Few prospective studies have explored the long-term prognostic value and warranty period of functional imaging in patients with stable chest pain. The CE-MARC (Clinical Evaluation of Magnetic Resonance in Coronary Heart Disease) trial recruited 752 patients with suspected angina and demonstrated the high diagnostic accuracy of stress cardiac magnetic resonance (CMR) compared with single-photon emission computed tomography (SPECT), using invasive coronary angiography as the reference standard.
This study aims to assess the comparative long-term prognostic value of stress CMR and SPECT and to establish operational warranty periods for normal test results.
Participants in the CE-MARC trial were followed up for major adverse cardiovascular events (MACE), including cardiovascular death, myocardial infarction, and unplanned coronary revascularization. The warranty period identified the time interval during which patients with a normal test result remained 97.5% free of MACE. Multivariable regression analysis identified key warranty period modifiers.
Of 752 recruited patients, 652 (86.9%) with CMR and SPECT with follow-up available formed the study cohort. At a median of 15.5 years (Q1-Q3: 12.4-16.6 years), 40 (6.1%) cardiovascular deaths occurred, 29 (4.4%) patients experienced a myocardial infarction, and 47 (7.2%) unplanned revascularization. After adjustment for cardiovascular risk factors, an abnormal CMR remained a strong independent MACE predictor (HR: 2.74; 95% CI: 1.70-4.42; P < 0.001). Patients with a normal test result had a warranty period of 6.8 years for stress CMR and 5.1 years for SPECT. Age, smoking, and diabetes identified higher-risk patients who had a reduced warranty period for a normal result.
In a long-term prospective study of patients with stable chest pain, stress CMR remained a strong, independent predictor of hard cardiovascular events, with a warranty period of almost 7 years for a normal scan. (Clinical Evaluation of Magnetic Resonance in Coronary Heart Disease; [CE-MARC]; ISRCTN77246133).

PMID:
42747370
Bibliographic data and abstract were imported from PubMed on 16 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.