Table 2.
Summary of clinical outcomes
| CMR-guided care (n=481) | SPECT-guided care (n=481) | NICE CG95 (2010) (n=240) | Total (n=1202) | |
| Number of events (number of patients) | 26 (18) | 22 (18) | 8 (6) | 56 (42) |
| Total follow-up (patient-years to first MACE or last contact) | 1396.8 | 1397.6 | 704.3 | 3498.7 |
| Annualised first MACE rate (%/year, 95% CI) | 1.29 (0.78 to 1.98) | 1.29 (0.78 to 1.98) | 0.85 (0.34 to 1.73) | 1.20 (0.87 to 1.60) |
| MACE within 1 year, % (95% CI) | 2.5 (1.4 to 4.4) | 2.5 (1.4 to 4.4) | 1.7 (0.6 to 4.4) | |
| Absolute difference (comparator—CMR, 95% CI) | – | 0.0 (−2.0 to 2.0) | −0.8 (−3.0 to 1.3) | |
| MACE within 3 years, % (95% CI) | 3.8 (2.4 to 5.9) | 3.8 (2.4 to 5.9) | 2.1 (0.9 to 5.0) | |
| Absolute difference (comparator—CMR, 95% CI) | – | 0.0 (−2.4 to 2.4) | −1.7 (−4.2 to 0.8) | |
| ‘Hard event’ within 1 year, % (95% CI) | 0.6 (0.2 to 1.9) | 0.4 (0.1 to 1.7) | 0.8 (0.2 to 3.3) | |
| Absolute difference (comparator—CMR, 95% CI) | – | −0.2 (−1.1 to 0.7) | 0.2 (−1.1 to 1.6) | |
| ‘Hard event’ within 3 years, % (95% CI) | 1.5 (0.7 to 3.1) | 1.1 (0.4 to 2.5) | 0.8 (0.2 to 3.3) | |
| Absolute difference (comparator—CMR, 95% CI) | – | −0.4 (−1.8 to 1.0) | −0.6 (−2.2 to 1.0) | |
| Frequency of individual MACE events | ||||
| Type 3 MI and CV death: MI* | – | 1 | – | 1 |
| CV death: MI* | – | 1 | 1 | 2 |
| CV death: pulmonary embolism* | – | 1 | – | 1 |
| CV death: stroke* | 1 | – | – | 1 |
| CV death: unknown* | – | 1 | – | 1 |
| Unplanned PCI | 7 | 5 | 2 | 14 |
| Unplanned CABG | 1 | – | – | 1 |
| Type 1 MI* | 7 | 1 | 2 | 10 |
| Type 2 MI* | – | 2 | – | 2 |
| Arrhythmia | 6 | 3 | 2 | 11 |
| Stroke/TIA | 4 | 3 | – | 7 |
| Heart failure | – | 4 | 1 | 5 |
| Non-MACE event | ||||
| Non-CV deaths | 7 | 1 | 2 | 10 |
| Previously published findings5 | ||||
| Primary outcome: unnecessary angiography within 12 months, n (%) | 36 (7.5) | 34 (7.1) | 69 (28.8) | 139 (11.6) |
| Secondary outcome: positive angiography within 12 months, n (%) | 47 (9.8) | 42 (8.7) | 29 (12.1) | 118 (9.8) |
*Denotes an event count as part of the post-hoc ‘hard event’ outcome measure, comprising CV death and non-fatal MI (excluding periprocedural MI due to PCI or CABG).
CABG, coronary artery bypass graft; CMR, cardiovascular magnetic resonance; CV, cardiovascular; MACE, major adverse cardiovascular event; MI, myocardial infarction; NICE, National Institute for Health and Care Excellence; PCI, percutaneous coronary intervention; SPECT, single-photon emission CT; TIA, transient ischaemic attack.