{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T19:15:00Z","timestamp":1769109300862,"version":"3.49.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,10,23]],"date-time":"2021-10-23T00:00:00Z","timestamp":1634947200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Instituto de Salud Carlos III and co-funded by Fondo Europeo de Desarrollo Regional","award":["PI20\/00637"],"award-info":[{"award-number":["PI20\/00637"]}]},{"name":"Instituto de Salud Carlos III and co-funded by Fondo Europeo de Desarrollo Regional","award":["CIBERCV16\/11\/00486"],"award-info":[{"award-number":["CIBERCV16\/11\/00486"]}]},{"DOI":"10.13039\/100009664","name":"Sociedad Espa\u00f1ola de Cardiolog\u00eda","doi-asserted-by":"publisher","award":["SEC\/FEC-INV-CLI 21\/024"],"award-info":[{"award-number":["SEC\/FEC-INV-CLI 21\/024"]}],"id":[{"id":"10.13039\/100009664","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011033","name":"Agencia Estatal de Investigaci\u00f3n","doi-asserted-by":"publisher","award":["FJC2020-043981-I\/AEI\/10.13039\/501100011033"],"award-info":[{"award-number":["FJC2020-043981-I\/AEI\/10.13039\/501100011033"]}],"id":[{"id":"10.13039\/501100011033","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Conselleria d\u2019Educaci\u00f3, Investigaci\u00f3, Cultura i Esport, Generalitat Valenciana","award":["AEST\/2019\/037"],"award-info":[{"award-number":["AEST\/2019\/037"]}]},{"name":"Conselleria d\u2019Educaci\u00f3, Investigaci\u00f3, Cultura i Esport, Generalitat Valenciana","award":["AEST\/2020\/029"],"award-info":[{"award-number":["AEST\/2020\/029"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>The role of revascularization in chronic coronary syndrome (CCS) and the value of ischaemia vs. anatomy to guide decision-making are in constant debate. We explored the potential of a combined assessment of ischaemic burden by vasodilator stress cardiovascular magnetic resonance (CMR) and presence of multivessel disease by angiography to predict the effect of revascularization on all-cause mortality in CCS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>The study group comprised 1066 CCS patients submitted to vasodilator stress CMR pre-cardiac catheterization (mean age 66\u2009\u00b1\u200911\u2009years, 69% male). Stress CMR-derived ischaemic burden (extensive if &amp;gt;5 ischaemic segments) and presence of multivessel disease in angiography (two- or three-vessel or left main stem disease) were computed. The influence of revascularization on all-cause mortality was explored and adjusted hazard ratios (HRs) with the corresponding 95% confidence intervals were obtained. During a median 7.51-year follow-up, 557 (52%) CMR-related revascularizations and 308 (29%) deaths were documented. Revascularization exerted a neutral effect on all-cause mortality in the whole study group [HR 0.94 (0.74\u20131.19), P\u2009=\u20090.6], in patients without multivessel disease [n\u2009=\u2009598, 56%, HR 1.12 (0.77\u20131.62), P\u2009=\u20090.6], and in those with multivessel disease without extensive ischaemic burden [n\u2009=\u2009181, 17%, HR 1.66 (0.91\u20133.04), P\u2009=\u20090.1]. However, compared to non-revascularized patients, revascularization significantly reduced all-cause mortality in patients with simultaneous multivessel disease and extensive ischaemic burden (n\u2009=\u2009287, 27%): 3.77 vs. 7.37 deaths per 100 person-years, HR 0.60 (0.40\u20130.90), P\u2009=\u20090.01.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In patients with CCS submitted to catheterization, evidence of simultaneous extensive CMR-related ischaemic burden and multivessel disease identifies the subset in whom revascularization can reduce all-cause mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwab170","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T15:57:14Z","timestamp":1633017434000},"page":"407-416","source":"Crossref","is-referenced-by-count":4,"title":["Combined assessment of stress cardiovascular magnetic resonance and angiography to predict the effect of revascularization in chronic coronary syndrome patients"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3483-7066","authenticated-orcid":false,"given":"Jose","family":"Gavara","sequence":"first","affiliation":[{"name":"Center for Biomaterials and Tissue Engineering, Universitat Polit\u00e8cnica de Val\u00e8ncia, Cam\u00ed de Vera s\/n, 46022 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4134-5278","authenticated-orcid":false,"given":"Nerea","family":"Perez","sequence":"additional","affiliation":[{"name":"Instituto de Investigacion Sanitaria INCLIVA,\u00a0Calle de Men\u00e9ndez y Pelayo 4, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Marcos-Garces","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Clinico Universitario de Valencia, Avenida Blasco Ib\u00e1\u00f1ez 17, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5547-2828","authenticated-orcid":false,"given":"Jose V","family":"Monmeneu","sequence":"additional","affiliation":[{"name":"Cardiovascular Magnetic Resonance Unit, Exploraciones Radiologicas Especiales (ERESA), Calle del Marqu\u00e9s de San Juan 6, 46015 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria P","family":"Lopez-Lereu","sequence":"additional","affiliation":[{"name":"Cardiovascular Magnetic Resonance Unit, Exploraciones Radiologicas Especiales (ERESA), Calle del Marqu\u00e9s de San Juan 6, 46015 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6405-6279","authenticated-orcid":false,"given":"Cesar","family":"Rios-Navarro","sequence":"additional","affiliation":[{"name":"Instituto de Investigacion Sanitaria INCLIVA,\u00a0Calle de Men\u00e9ndez y Pelayo 4, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"De Dios","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red - Cardiovascular (CIBER-CV), Avenida Monforte de Lemos 3-5, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clara","family":"Bonanad","sequence":"additional","affiliation":[{"name":"Instituto de Investigacion Sanitaria INCLIVA,\u00a0Calle de Men\u00e9ndez y Pelayo 4, 46010 Valencia, Spain"},{"name":"Department of Cardiology, Hospital Clinico Universitario de Valencia, Avenida Blasco Ib\u00e1\u00f1ez 17, 46010 Valencia, Spain"},{"name":"Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Avenida Blasco Ib\u00e1\u00f1ez 17, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joaquim","family":"C\u00e1noves","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Clinico Universitario de Valencia, Avenida Blasco Ib\u00e1\u00f1ez 17, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Moratal","sequence":"additional","affiliation":[{"name":"Center for Biomaterials and Tissue Engineering, Universitat Polit\u00e8cnica de Val\u00e8ncia, Cam\u00ed de Vera s\/n, 46022 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5040-0924","authenticated-orcid":false,"given":"Patricia","family":"Palau","sequence":"additional","affiliation":[{"name":"Instituto de Investigacion Sanitaria INCLIVA,\u00a0Calle de Men\u00e9ndez y Pelayo 4, 46010 Valencia, Spain"},{"name":"Department of Cardiology, Hospital Clinico Universitario de Valencia, Avenida Blasco Ib\u00e1\u00f1ez 17, 46010 Valencia, Spain"},{"name":"Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Avenida Blasco Ib\u00e1\u00f1ez 17, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gema","family":"Mi\u00f1ana","sequence":"additional","affiliation":[{"name":"Instituto de Investigacion Sanitaria INCLIVA,\u00a0Calle de Men\u00e9ndez y Pelayo 4, 46010 Valencia, Spain"},{"name":"Department of Cardiology, Hospital Clinico Universitario de Valencia, Avenida Blasco Ib\u00e1\u00f1ez 17, 46010 Valencia, Spain"},{"name":"Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Avenida Blasco Ib\u00e1\u00f1ez 17, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julio","family":"Nunez","sequence":"additional","affiliation":[{"name":"Instituto de Investigacion Sanitaria INCLIVA,\u00a0Calle de Men\u00e9ndez y Pelayo 4, 46010 Valencia, Spain"},{"name":"Department of Cardiology, Hospital Clinico Universitario de Valencia, Avenida Blasco Ib\u00e1\u00f1ez 17, 46010 Valencia, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red - Cardiovascular (CIBER-CV), Avenida Monforte de Lemos 3-5, 28029 Madrid, Spain"},{"name":"Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Avenida Blasco Ib\u00e1\u00f1ez 17, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4613-5459","authenticated-orcid":false,"given":"Francisco Javier","family":"Chorro","sequence":"additional","affiliation":[{"name":"Instituto de Investigacion Sanitaria INCLIVA,\u00a0Calle de Men\u00e9ndez y Pelayo 4, 46010 Valencia, Spain"},{"name":"Department of Cardiology, Hospital Clinico Universitario de Valencia, Avenida Blasco Ib\u00e1\u00f1ez 17, 46010 Valencia, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red - Cardiovascular (CIBER-CV), Avenida Monforte de Lemos 3-5, 28029 Madrid, Spain"},{"name":"Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Avenida Blasco Ib\u00e1\u00f1ez 17, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6425-5828","authenticated-orcid":false,"given":"Vicente","family":"Bodi","sequence":"additional","affiliation":[{"name":"Instituto de Investigacion Sanitaria INCLIVA,\u00a0Calle de Men\u00e9ndez y Pelayo 4, 46010 Valencia, Spain"},{"name":"Department of Cardiology, Hospital Clinico Universitario de Valencia, Avenida Blasco Ib\u00e1\u00f1ez 17, 46010 Valencia, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red - Cardiovascular (CIBER-CV), Avenida Monforte de Lemos 3-5, 28029 Madrid, Spain"},{"name":"Department of Medicine, Faculty of Medicine and Odontology, University of Valencia, Avenida Blasco Ib\u00e1\u00f1ez 17, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,10,23]]},"reference":[{"key":"2022031209200276200_zwab170-B1","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1038\/s41569-018-0006-z","article-title":"Revascularization in stable coronary disease: evidence and uncertainties","volume":"15","author":"Katritsis","year":"2018","journal-title":"Nat Rev Cardiol"},{"key":"2022031209200276200_zwab170-B2","doi-asserted-by":"crossref","first-page":"2503","DOI":"10.1056\/NEJMoa0805796","article-title":"A randomized trial of therapies for type 2 diabetes and coronary artery disease","volume":"360","author":"Frye","year":"2009","journal-title":"N Engl J Med"},{"key":"2022031209200276200_zwab170-B3","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1056\/NEJMoa070829","article-title":"Optimal medical therapy with or without PCI for stable coronary disease","volume":"356","author":"Boden","year":"2007","journal-title":"N Engl J Med"},{"key":"2022031209200276200_zwab170-B4","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1056\/NEJMoa1915922","article-title":"Initial invasive or conservative strategy for stable coronary disease","volume":"382","author":"Maron","year":"2020","journal-title":"N Engl J Med"},{"key":"2022031209200276200_zwab170-B5","doi-asserted-by":"crossref","first-page":"1674","DOI":"10.1016\/j.jcmg.2020.02.027","article-title":"Vasodilator stress CMR and all-cause mortality in stable ischemic heart disease: a large retrospective registry","volume":"13","author":"Marcos-Garces","year":"2020","journal-title":"J Am Coll Cardiol Imaging"},{"key":"2022031209200276200_zwab170-B6","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1016\/j.jacc.2012.07.013","article-title":"2012 ACCF\/AHA\/ACP\/AATS\/PCNA\/SCAI\/STS Guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology Foundation\/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons","volume":"60","author":"Fihn","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"2022031209200276200_zwab170-B7","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1001\/jama.2016.12680","article-title":"Effect of care guided by cardiovascular magnetic resonance, myocardial perfusion scintigraphy, or NICE guidelines on subsequent unnecessary angiography rates: the CE-MARC 2 randomized clinical trial","volume":"316","author":"Greenwood","year":"2016","journal-title":"JAMA"},{"key":"2022031209200276200_zwab170-B8","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1016\/j.jacc.2007.06.016","article-title":"Prognostic value of dipyridamole stress cardiovascular magnetic resonance imaging in patients with known or suspected coronary artery disease","volume":"50","author":"Bodi","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"2022031209200276200_zwab170-B9","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1148\/radiol.11110134","article-title":"Prognostic implications of dipyridamole cardiac MR imaging: a prospective multicenter registry","volume":"262","author":"Bodi","year":"2012","journal-title":"Radiology"},{"key":"2022031209200276200_zwab170-B10","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1161\/hc0402.102975","article-title":"Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association","volume":"105","author":"Cerqueira","year":"2002","journal-title":"Circulation"},{"key":"2022031209200276200_zwab170-B11","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.jcmg.2010.11.012","article-title":"Long-term prognostic value of dobutamine stress CMR","volume":"4","author":"Kelle","year":"2011","journal-title":"J Am Coll Cardiol Imaging"},{"key":"2022031209200276200_zwab170-B12","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1093\/eurheartj\/ehm212","article-title":"Angiographic estimates of myocardium at risk during acute myocardial infarction: validation study using cardiac magnetic resonance imaging","volume":"28","author":"Ortiz-Perez","year":"2007","journal-title":"Eur Heart J"},{"key":"2022031209200276200_zwab170-B13","first-page":"1","article-title":"Impact of revascularisation on outcomes in chronic coronary syndromes: a new metaanalysis with the same old biases?","author":"Brown","year":"2021","journal-title":"Eur Heart J"},{"key":"2022031209200276200_zwab170-B14","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.3390\/jcm9061957","article-title":"A novel clinical and stress cardiac magnetic resonance (C-CMR-10) score to predict long-term all-cause mortality in patients with known or suspected chronic coronary syndrome","volume":"9","author":"Marcos-Garces","year":"2020","journal-title":"J Clin Med"},{"key":"2022031209200276200_zwab170-B15","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/eurheartj\/ehy394","article-title":"ESC\/EACTS guidelines on myocardial revascularization","volume":"40","author":"Neumann","year":"2019","journal-title":"Eur Heart J"},{"key":"2022031209200276200_zwab170-B16","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/j.1467-6419.2007.00527.x","article-title":"Some practical guidance for the implementation of propensity score matching","volume":"22","author":"Caliendo","year":"2008","journal-title":"J Econ Surv"},{"key":"2022031209200276200_zwab170-B17","doi-asserted-by":"crossref","first-page":"2900","DOI":"10.1161\/01.CIR.0000072790.23090.41","article-title":"Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography","volume":"107","author":"Hachamovitch","year":"2003","journal-title":"Circulation"},{"key":"2022031209200276200_zwab170-B18","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1093\/eurheartj\/ehq500","article-title":"Impact of ischaemia and scar on the therapeutic benefit derived from myocardial revascularization vs. medical therapy among patients undergoing stress-rest myocardial perfusion scintigraphy","volume":"32","author":"Hachamovitch","year":"2011","journal-title":"Eur Heart J"}],"container-title":["European Journal of Preventive Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurjpc\/article-pdf\/29\/2\/407\/42855090\/zwab170.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/article-pdf\/29\/2\/407\/42855090\/zwab170.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,12]],"date-time":"2022-03-12T09:20:29Z","timestamp":1647076829000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjpc\/article\/29\/2\/407\/6408982"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,23]]},"references-count":18,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,10,23]]},"published-print":{"date-parts":[[2022,3,11]]}},"URL":"https:\/\/doi.org\/10.1093\/eurjpc\/zwab170","relation":{},"ISSN":["2047-4873","2047-4881"],"issn-type":[{"value":"2047-4873","type":"print"},{"value":"2047-4881","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,1,1]]},"published":{"date-parts":[[2021,10,23]]}}}