CCS Class 2 and 3AND EITHER: 2 or more of the following risk factors (diabetes, hypertension, smoking, family history, hypercholesterolaemia) OR Positive Exercise treadmill/bicycle test
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Contra-indications to CMR
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Contra-indications to adenosine (AV-block2 or 3, symptomatic bradycardia, COPD with evidence of bronchospasm or asthma)
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Cardiac arrhythmias which may compromise image quality, atrial fibrillation or frequent ectopic beats > 20 bpm)
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Age > 18 yrs
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Known Left ventricular ejection fraction of less than 30%
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Willing to undergo all study procedures
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Persistent CCS class 4 angina
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NYHA class 3 and 4
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Previous coronary artery bypass grafts
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PCI within the previous 6 months
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Poor renal function (GFR < 30 ml/min) and /or allergy to contrast media
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Inability to lie supine for 60 mins
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Unstable medically
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Participating in any other clinical trial
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Pregnancy / breast feeding |