Modelización de activos cotizados mediante modelos de difusión estocásticos de tipo Itô

[ES] En este Trabajo Final de Grado (TFG), se estudiará el Modelo Estocástico Log-Normal, basado en un proceso estocástico denominado Movimiento Browniano Geométrico (MBG), para una acción de la compañía Grifols que cotiza dentro del IBEX-35. A partir de un histórico de cotizaciones se pretende realizar predicciones para el valor de dicha acción. El MBG es un modelo estocásticos perteneciente a la denominada familia de modelos de un factor y está basado en por una Ecuación Diferencial Estocástica de tipo Itô que contiene en su formulación la tendencia y la difusión del subyacente financiero. Previamente a la aplicación del modelo para realizar predicciones es necesario estimar sus parámetros. Para lo que se aplicarán dos métodos, el Método de los Momentos Estadísticos y el Método de Máxima Verosimilitud adaptados al contexto de las Ecuaciones Diferenciales Estocásticas, con el objeto de obtener estimaciones robustas. Una vez estimados los parámetros se llevará a cabo la validación del modelo. Esto se realizará mediante diversas medidas de bondad de ajuste tales como, el Error Cuadrático Medio (ECM) y el Error Porcentual Absoluto Medio (MAPE). Para finalizar, se mostrarán a través de gráficos y mediante valores numéricos los cálculos de las estimaciones puntuales (función media) y por intervalos de confianza al 95%, que constituirán las predicciones del modelo para la acción Grifols.[EN] In this Final Work of Degree (TFG), will study the Stochastic Model Log-Normal, based in a stochastic process designated Movement Browniano Geometrical (MBG), for an action of the company Grifols that quotes inside the IBEX-35. From a historical of contributions pretends make predictions for the value of said action. The MBG is a pertaining stochastic model to the designated family of models of a factor and is based in by a Stochastic Differential Equation of type Itô that contains in his formulation the tendency and the diffusion of the underlying financial. Previously to the application of the model to make predictions is necessary to estimate his parameters. For what will apply two methods, the Method of the Statistical Moments and the Method of Maximum Verosimilitud adapted to the context of the Stochastic Differential Equations, with the object to obtain robust estimates. Once estimated the parameters will carry out the validation of the model. This will make by means of diverse measures of goodness of adjust such as, the Half Quadratic Error (ECM) and the Error Porcentual Absolute Half (MAPE). To finalise, will show through charts and by means of numerical values the calculations of the punctual estimates (half function) and by intervals of confidence to 95%, that will constitute the predictions of the model for the action Grifols.Miñana Sellés, G. (2018). Modelización de activos cotizados mediante modelos de difusión estocásticos de tipo Itô. http://hdl.handle.net/10251/101513TFG

Intrarenal venous flow in cardiorenal syndrome : a shining light into the darkness

The aim of this case report is to assess the potential role of intrarenal Doppler ultrasonography as a non-invasive method to evaluate intrarenal venous flow (IRVF) in acute heart failure (AHF) and concomitant renal dysfunction. We report a case of an 81-year-old woman with valvular heart disease (previous mitral valve replacement) that presented with acutely decompensated heart failure and concomitant worsening renal function (WRF). In addition to complete physical examination, laboratory analysis, and echocardiography, IRVF was assessed at baseline and 48 h after the administration of diuretic treatment. At admission, physical examination and echocardiography revealed signs of intravascular congestion (jugular venous distension and severely dilated inferior vena cava). In addition, a significant increase in serum creatinine from 1.23 to 1.81 mg/dL was noted without signs of hypoperfusion at clinical evaluation. At baseline, intrarenal Doppler ultrasonography showed a monophasic IRVF pattern indicating a severely elevated interstitial renal pressure. After aggressive decongestion, a dynamic behaviour was found in IRVF changing from monophasic to biphasic pattern in parallel with an improvement in clinical parameters and renal function (serum creatinine changed from 1.81 to 1.44 mg/dL). In this case of a patient with AHF and WRF, IRVF changed after aggressive decongestion in agreement with clinical evolution. According to these findings, this technique could provide valuable information for identifying patients with a 'congestion kidney failure' phenotype. Further studies are needed confirming this observation and evaluating the potential role of this technique for guiding decongestive therapy in patients with AHF and WRF

Serum Neprilysin and Recurrent Admissions in Patients With Heart Failure

Our aim was to evaluate the association between the soluble form of neprilysin () levels and long-term all-cause, cardiovascular, and acute heart failure () recurrent admissions in an ambulatory cohort of patients with heart failure. has emerged as a new biomarker with promising implications for prognosis and therapy in patients with heart failure. Reducing the recurrent admission rate of heart failure patients has become an important target of public health planning strategies. We measured levels in 1021 consecutive ambulatory heart failure patients. End points were the number of all-cause, cardiovascular, and hospitalizations during follow-up. We used covariate-adjusted incidence rate ratios to identify associations. At a median follow-up of 3.4 years (interquartile range: 1.8-5.7), 391 (38.3%) patients died, 477 (46.7%) patients had 1901 all-cause admissions, 324 (31.7%) patients had 770 cardiovascular admissions, and 218 (21.4%) patients had 488 admissions. The medians for and amino-terminal pro-brain natriuretic peptide were 0.64 ng/mL (interquartile range: 0.39-1.22) and 1248 pg/mL (interquartile range: 538-2825), respectively. In a multivariate setting, the adjusted incidence rate ratios for the top (>1.22 ng/mL) versus the bottom (≤0.39 ng/mL) quartiles of were 1.37 (95% confidence interval: 1.03-1.82), P =0.032; 1.51 (95% confidence interval: 1.10-2.06), P =0.010; and 1.51 (95% confidence interval: 1.05-2.16), P =0.026 for all-cause, cardiovascular, and admissions, respectively. Elevated levels predicted an increased risk of recurrent all-cause, cardiovascular, and admissions in ambulatory patients with heart failure

Rehospitalization burden and morbidity risk in patients with heart failure with mid-range ejection fraction

Heart failure with mid-range ejection fraction (HFmrEF) has been proposed as a distinct HF phenotype, but whether patients on this category fare worse, similarly, or better than those with HF with reduced EF (HFrEF) or preserved EF (HFpEF) in terms of rehospitalization risks over time remains unclear. We prospectively included 2961 consecutive patients admitted for acute HF (AHF) in our institution. Of them, 158 patients died during the index admission, leaving the sample size to be 2803 patients. Patients were categorized according to their EF: HFrEF if EF ≤ 40% (n = 908, 32.4%); HFmrEF if EF = 41-49% (n = 449, 16.0%); and HFpEF if EF ≥ 50% (n = 1446, 51.6%). Covariate-adjusted incidence rate ratios (IRRs) were used to evaluate the association between EF status and recurrent all-cause and HF-related admissions. At a median follow-up of 2.6 years (inter-quartile range: 1.0-5.3), 1663 (59.3%) patients died, and 6035 all-cause readmissions were registered in 2026 patients (72.3%), 2163 of them HF related. Rates of all-cause readmission per 100 patients-years of follow-up were 150.1, 176.9, and 163.6 in HFrEF, HFmrEF, and HFpEF, respectively (P = 0.097). After multivariable adjustment, when compared with that of patients with HFrEF and HFpEF, HFmrEF status was not significantly associated with a different risk of all-cause readmissions (IRR = 0.99; 95% confidence interval [CI], 0.77-1.27; P = 0.926; and IRR = 0.93; 95% CI, 0.74-1.18; P = 0.621, respectively) or HF-related readmissions (IRR = 1.06; 95% CI, 0.77-1.46; P = 0.725; and IRR = 1.11; 95% CI, 0.82-1.50; P = 0.511, respectively). Following an admission for AHF, patients with HFmrEF had a similar rehospitalization burden and a similar risk of recurrent all-cause and HF-related admissions than had patients with HFrEF or HFpEF. Regarding morbidity risk, HFmrEF seems not to be a distinct HF phenotype

Right Ventricular Dysfunction Staging System for Mortality Risk Stratifiction in Heart Failure with Preserved Ejection Fraction

Right ventricular dysfunction (RVD) parameters are increasingly important features in heart failure with preserved ejection fraction (HFpEF). We sought to evaluate the prognostic impact of a progressive RVD staging system by combining the tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (TAPSE/PASP) ratio with functional tricuspid regurgitation (TR) severity. We prospectively included 1355 consecutive HFpEF patients discharged for acute heart failure (HF). Of them, in 471 (34.7%) patients, PASP could not be accurately measured, leaving the final sample size to be 884 patients. Patients were categorized as Stage 1: TAPSE/PASP ≥ 0.36 without significant TR; stage 2: TAPSE/PASP ≥ 0.36 with significant TR; stage 3: TAPSE/PASP < 0.36 without significant TR; and stage 4: TAPSE/PASP < 0.36 with significant TR. By the 1 year follow-up, 207 (23.4%) patients had died. We found a significant and graded association between RVD stages and mortality rates (15.8%, 25%, 31.2%, and 45.4% from stage 1 to stage 4, respectively; log-rank test, p < 0.001). After multivariable adjustment, and compared to stage 1, stages 3 and 4 were independently associated with mortality risk (HR: 1.8219; 95% CI 1.308-2.538; p < 0.001 and HR = 2.2632; 95% CI 1.540-3.325; p < 0.001, respectively). A RVD staging system, integrating TAPSE/PASP and TR, provides a comprehensive and widely available tool for risk stratification in HFpEF

Role of PCSK9 in the course of ejection fraction change after ST-segment elevation myocardial infarction : a pilot study

Altres ajuts: Conselleria d'Educació, Investigació, Cultura i Esport GV/2018/116Proprotein convertase subtilisin/kexin type 9 (PCSK9) has emerged as a therapeutic target for reducing plasma low-density lipoprotein cholesterol. Beyond lipid control, recent findings suggest a deleterious effect of this protein in the pathogenesis of postmyocardial infarction left ventricle remodelling and heart failure-related complications. The aim of this study was to assess the relationship between circulating PCSK9 and 6 month cardiac magnetic resonance imaging-derived left ventricular ejection fraction (LVEF) after a first ST-segment elevation myocardial infarction (STEMI). We prospectively evaluated 40 patients with a first STEMI, LVEF < 50% and treated with primary percutaneous coronary intervention in which PCSK9 was measured 24 h postreperfusion. All patients underwent cardiac magnetic resonance imaging 1 week and 6 months after STEMI. Baseline characteristics were compared across median values of PCSK9. The association between PCSK9 levels and LVEF at 6 months was evaluated by analysis of covariance. The mean age of the sample was 60 ± 12 years and 33 (82.5%) were male patients. The infarct location was anterior in 27 patients (67.5%), and 9 patients (22.5%) were Killip class ≥ II. The mean 1 week and 6 month LVEF were 41 ± 7% and 48 ± 10%, respectively. The mean PCSK9 was 1.93 ± 0.38 U/mL. Testing the association between serum PCSK9 and 6 month LVEF with analysis of covariance revealed an inverse relationship (r = −0.35, P = 0.028). After multivariate adjustment, circulating PCSK9 remained significant and inversely associated with 6 month LVEF (P = 0.002). In patients with a first STEMI with reduced ejection fraction at index admission and treated with primary percutaneous coronary intervention, circulating PCSK9 was associated with lower LVEF at 6 months

Renal function dynamics following co-administration of sacubitril/valsartan and empagliflozin in patients with heart failure and type 2 diabetes

The aim of this study was to evaluate the safety profile in terms of changes in renal function after co-treatment with sacubitril/valsartan and empagliflozin in patients with type 2 diabetes (T2D) and heart failure with reduced ejection fraction (HFrEF). This multicentre observational analysis included 108 patients with T2D and HFrEF treated with both agents: baseline sacubitril/valsartan (Group A; n = 43), baseline empagliflozin (Group B; n = 42), or both agents initiated simultaneously (Group C; n = 23). The primary endpoint was estimated glomerular filtration rate (eGFR) dynamics across treatment groups. A binary characterization of worsening renal function (WRF)/improved renal function (IRF) was included in the primary endpoint. WRF and IRF were defined as an increase/decrease in serum creatinine ≥ 0.3 mg/dL or GFR ≥ 20%. Changes in quantitative variables were evaluated using joint modelling of survival and longitudinal data (JM). Rates and their treatment differences were determined by Poisson regression. The mean left ventricle ejection fraction and eGFR were 32 ± 6% and 70 ± 28 mL/min/1.73 m 2, respectively. At a median follow-up of 1.01 years (inter-quartile range 0.71-1.50), 377 outpatient visits were recorded. Although there were differences in GFR trajectories over time within each treatment, they did not achieve statistical significance (omnibus P = 0.154). However, when these differences were contrasted among groups, there was a significant decrease in GFR in Group A as compared with Group B (P = 0.002). The contrast between Groups C and B was not significant (P = 0.430). These differences were also reflected when the rates for WRF and IRF were contrasted among treatments. The co-administration of sacubitril/valsartan and empagliflozin in patients with HFrEF and concomitant T2D appears to be safe in terms of renal function

Sex-Related Differences in Mortality Following Admission for Acute Heart Failure Across the Left Ventricular Ejection Fraction Spectrum

Following a heart failure (HF)-decompensation, there is scarce data about sex-related prognostic differences across left ventricular ejection fraction (LVEF) status. We sought to evaluate sex-related differences in 6-month mortality risk across LVEF following admission for acute HF. We retrospectively evaluated 4812 patients consecutively admitted for acute HF in a multicenter registry from 3 hospitals. Study end points were all-cause, cardiovascular, and HF-related mortality at 6-month follow-up. Multivariable Cox regression models were fitted to investigate sex-related differences across LVEF. A total of 2243 (46.6%) patients were women, 2569 (53.4%) were men, and 2608 (54.2%) showed LVEF≥50%. At 6-month follow-up, 645 patients died (13.4%), being 544 (11.3%) and 416 (8.6%) cardiovascular and HF-related deaths, respectively. LVEF was not independently associated with mortality (HR, 1.02; 95% CI 0.99-1.05; P =0.135). After multivariable adjustment, we found no sex-related differences in all-cause mortality (P value for interaction=0.168). However, a significant interaction between sex and cardiovascular and HF mortality risks was found across LVEF (P value for interaction=0.030 and 0.007, respectively). Compared with men, women had a significantly lower risk of cardiovascular and HF-mortality at LVEF80%). Following an admission for acute HF, no sex-related differences were found in all-cause mortality risk. However, when compared with men, women showed a lower risk of cardiovascular and HF-mortality at the lower extreme of LVEF. On the contrary, they showed a higher risk of HF death at the upper extreme

Coronary Revascularization and Long-Term Survivorship in Chronic Coronary Syndrome

Ischemic heart disease (IHD) persists as the leading cause of death in the Western world. In recent decades, great headway has been made in reducing mortality due to IHD, based around secondary prevention. The advent of coronary revascularization techniques, first coronary artery bypass grafting (CABG) surgery in the 1960s and then percutaneous coronary intervention (PCI) in the 1970s, has represented one of the major breakthroughs in medicine during the last century. The benefit provided by these techniques, especially PCI, has been crucial in lowering mortality rates in acute coronary syndrome (ACS). However, in the setting where IHD is most prevalent, namely chronic coronary syndrome (CCS), the increase in life expectancy provided by coronary revascularization is controversial. Over more than 40 years, several clinical trials have been carried out comparing optimal medical treatment (OMT) alone with a strategy of routine coronary revascularization on top of OMT. Beyond a certain degree of symptomatic improvement and lower incidence of minor events, routine invasive management has not demonstrated a convincing effect in terms of reducing mortality in CCS. Based on the accumulated evidence more than half a century after the first revascularization procedures were used, invasive management should be considered in those patients with uncontrolled symptoms despite OMT or high-risk features related to left ventricular function, coronary anatomy, or functional assessment, taking into account the patient expectations and preferences

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

[EN] Vasodilator stress cardiac magnetic resonance (stressCMR) has shown robust diagnostic and prognostic value in patients with known or suspected chronic coronary syndrome (CCS). However, it is unknown whether integration of stressCMR with clinical variables in a simple clinical-imaging score can straightforwardly predict all-cause mortality in this population. We included 6187 patients in a large registry that underwent stressCMR for known or suspected CCS. Several clinical and stressCMR variables were collected, such as left ventricular ejection fraction (LVEF) and ischemic burden (number of segments with stress-induced perfusion defects (PD)). During a median follow-up of 5.56 years, we registered 682 (11%) all-cause deaths. The only independent predictors of all-cause mortality in multivariable analysis were age, male sex, diabetes mellitus (DM), LVEF and ischemic burden. Based on the weight of the chi-square increase at each step of the multivariable analysis, we created a simple clinical-stressCMR (C-CMR-10) score that included these variables (age >= 65 years = 3 points, LVEF 5 segments = 1 point). This 0 to 10 points C-CMR-10 score showed good performance to predict all-cause annualized mortality rate ranging from 0.29%/year (score = 0) to >4.6%/year (score >= 7). The goodness of the model and of the C-CMR-10 score was separately confirmed in 2 internal cohorts (n> 3000 each). We conclude that a novel and simple clinical-stressCMR score, which includes clinical and stressCMR variables, can provide robust prediction of the risk of long-term all-cause mortality in a population of patients with known or suspected CCS.This work was supported by the Instituto de Salud Carlos III and co-funded by Fondo Europeo de Desarrollo Regional (FEDER) (grant numbers PI17/01836 and CIBERCV16/11/00486).Marcos-Garces, V.; Gavara-Doñate, J.; Monmeneu-Menadas, JV.; Lopez-Lereu, MP.; Pérez, N.; Rios-Navarro, C.; De Dios, E.... (2020). 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. Journal of Clinical Medicine. 9(6):1-13. https://doi.org/10.3390/jcm9061957S11396Hendel, R. C., Friedrich, M. G., Schulz-Menger, J., Zemmrich, C., Bengel, F., Berman, D. S., … Nagel, E. (2016). CMR First-Pass Perfusion for Suspected Inducible Myocardial Ischemia. JACC: Cardiovascular Imaging, 9(11), 1338-1348. doi:10.1016/j.jcmg.2016.09.010Chang, S.-A., & Kim, R. J. (2016). The Use of Cardiac Magnetic Resonance in Patients with Suspected Coronary Artery Disease: A Clinical Practice Perspective. Journal of Cardiovascular Ultrasound, 24(2), 96. doi:10.4250/jcu.2016.24.2.96Kiaos, A., Tziatzios, I., Hadjimiltiades, S., Karvounis, C., & Karamitsos, T. D. (2018). Diagnostic performance of stress perfusion cardiac magnetic resonance for the detection of coronary artery disease. International Journal of Cardiology, 252, 229-233. doi:10.1016/j.ijcard.2017.11.066Li, M., Zhou, T., Yang, L., Peng, Z., Ding, J., & Sun, G. (2014). Diagnostic Accuracy of Myocardial Magnetic Resonance Perfusion to Diagnose Ischemic Stenosis With Fractional Flow Reserve as Reference. JACC: Cardiovascular Imaging, 7(11), 1098-1105. doi:10.1016/j.jcmg.2014.07.011Siontis, G. C., Mavridis, D., Greenwood, J. P., Coles, B., Nikolakopoulou, A., Jüni, P., … Windecker, S. (2018). Outcomes of non-invasive diagnostic modalities for the detection of coronary artery disease: network meta-analysis of diagnostic randomised controlled trials. BMJ, k504. doi:10.1136/bmj.k504Nagel, E., Greenwood, J. P., McCann, G. P., Bettencourt, N., Shah, A. M., Hussain, S. T., … Berry, C. (2019). Magnetic Resonance Perfusion or Fractional Flow Reserve in Coronary Disease. New England Journal of Medicine, 380(25), 2418-2428. doi:10.1056/nejmoa1716734Siontis, G. C., Branca, M., Serruys, P., Silber, S., Räber, L., Pilgrim, T., … Hunziker, L. (2019). Impact of left ventricular function on clinical outcomes among patients with coronary artery disease. European Journal of Preventive Cardiology, 26(12), 1273-1284. doi:10.1177/2047487319841939Buckert, D., Kelle, S., Buss, S., Korosoglou, G., Gebker, R., Birkemeyer, R., … Bernhardt, P. (2016). Left ventricular ejection fraction and presence of myocardial necrosis assessed by cardiac magnetic resonance imaging correctly risk stratify patients with stable coronary artery disease: a multi-center all-comers trial. Clinical Research in Cardiology, 106(3), 219-229. doi:10.1007/s00392-016-1042-5Catalano, O., Moro, G., Perotti, M., Frascaroli, M., Ceresa, M., Antonaci, S., … Priori, S. G. (2012). Late gadolinium enhancement by cardiovascular magnetic resonance is complementary to left ventricle ejection fraction in predicting prognosis of patients with stable coronary artery disease. Journal of Cardiovascular Magnetic Resonance, 14(1). doi:10.1186/1532-429x-14-29Lipinski, M. J., McVey, C. M., Berger, J. S., Kramer, C. M., & Salerno, M. (2013). Prognostic Value of Stress Cardiac Magnetic Resonance Imaging in Patients With Known or Suspected Coronary Artery Disease. Journal of the American College of Cardiology, 62(9), 826-838. doi:10.1016/j.jacc.2013.03.080Gargiulo, P., Dellegrottaglie, S., Bruzzese, D., Savarese, G., Scala, O., Ruggiero, D., … Filardi, P. P. (2013). The Prognostic Value of Normal Stress Cardiac Magnetic Resonance in Patients With Known or Suspected Coronary Artery Disease. Circulation: Cardiovascular Imaging, 6(4), 574-582. doi:10.1161/circimaging.113.000035Kwong, R. Y., Ge, Y., Steel, K., Bingham, S., Abdullah, S., Fujikura, K., … Simonetti, O. P. (2019). Cardiac Magnetic Resonance Stress Perfusion Imaging for Evaluation of Patients With Chest Pain. Journal of the American College of Cardiology, 74(14), 1741-1755. doi:10.1016/j.jacc.2019.07.074Marcos-Garces, V., Gavara, J., Monmeneu, J. V., Lopez-Lereu, M. P., Bosch, M. J., Merlos, P., … Bodi, V. (2020). Vasodilator Stress CMR and All-Cause Mortality in Stable Ischemic Heart Disease. JACC: Cardiovascular Imaging, 13(8), 1674-1686. doi:10.1016/j.jcmg.2020.02.027Heitner, J. F., Kim, R. J., Kim, H. W., Klem, I., Shah, D. J., Debs, D., … Judd, R. M. (2019). Prognostic Value of Vasodilator Stress Cardiac Magnetic Resonance Imaging. JAMA Cardiology, 4(3), 256. doi:10.1001/jamacardio.2019.0035Bodi, V., Sanchis, J., Lopez-Lereu, M. P., Nunez, J., Mainar, L., Monmeneu, J. V., … Llacer, A. (2007). Prognostic Value of Dipyridamole Stress Cardiovascular Magnetic Resonance Imaging in Patients With Known or Suspected Coronary Artery Disease. Journal of the American College of Cardiology, 50(12), 1174-1179. doi:10.1016/j.jacc.2007.06.016Bodi, V., Husser, O., Sanchis, J., Núñez, J., Monmeneu, J. V., López-Lereu, M. P., … Llacer, Á. (2012). Prognostic Implications of Dipyridamole Cardiac MR Imaging: A Prospective Multicenter Registry. Radiology, 262(1), 91-100. doi:10.1148/radiol.11110134Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G. F., Coats, A. J. S., … van der Meer, P. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European Heart Journal, 37(27), 2129-2200. doi:10.1093/eurheartj/ehw128Marschner, I. C., Colquhoun, D., Simes, R. J., Glasziou, P., Harris, P., Singh, B. B., … Tonkin, A. (2001). Long-term risk stratification for survivors of acute coronary syndromes. Journal of the American College of Cardiology, 38(1), 56-63. doi:10.1016/s0735-1097(01)01360-2Knuuti, J., Wijns, W., Saraste, A., Capodanno, D., Barbato, E., Funck-Brentano, C., … Cuisset, T. (2019). 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. European Heart Journal, 41(3), 407-477. doi:10.1093/eurheartj/ehz425Klem, I., Shah, D. J., White, R. D., Pennell, D. J., van Rossum, A. C., Regenfus, M., … Kim, R. J. (2011). Prognostic Value of Routine Cardiac Magnetic Resonance Assessment of Left Ventricular Ejection Fraction and Myocardial Damage. Circulation: Cardiovascular Imaging, 4(6), 610-619. doi:10.1161/circimaging.111.964965Grothues, F., Smith, G. C., Moon, J. C. ., Bellenger, N. G., Collins, P., Klein, H. U., & Pennell, D. J. (2002). Comparison of interstudy reproducibility of cardiovascular magnetic resonance with two-dimensional echocardiography in normal subjects and in patients with heart failure or left ventricular hypertrophy. The American Journal of Cardiology, 90(1), 29-34. doi:10.1016/s0002-9149(02)02381-0Timmis, A., Raharja, A., Archbold, R. A., & Mathur, A. (2018). Validity of inducible ischaemia as a surrogate for adverse outcomes in stable coronary artery disease. Heart, 104(21), 1733-1738. doi:10.1136/heartjnl-2018-313230Pontone, G., Andreini, D., Bertella, E., Loguercio, M., Guglielmo, M., Baggiano, A., … Masci, P. G. (2015). Prognostic value of dipyridamole stress cardiac magnetic resonance in patients with known or suspected coronary artery disease: a mid-term follow-up study. European Radiology, 26(7), 2155-2165. doi:10.1007/s00330-015-4064-xHeydari, B., Juan, Y.-H., Liu, H., Abbasi, S., Shah, R., Blankstein, R., … Kwong, R. Y. (2016). Stress Perfusion Cardiac Magnetic Resonance Imaging Effectively Risk Stratifies Diabetic Patients With Suspected Myocardial Ischemia. Circulation: Cardiovascular Imaging, 9(4). doi:10.1161/circimaging.115.004136Vincenti, G., Masci, P. G., Monney, P., Rutz, T., Hugelshofer, S., Gaxherri, M., … Schwitter, J. (2017). Stress Perfusion CMR in Patients With Known and Suspected CAD. JACC: Cardiovascular Imaging, 10(5), 526-537. doi:10.1016/j.jcmg.2017.02.006Buckert, D., Cieslik, M., Tibi, R., Radermacher, M., Rottbauer, W., & Bernhardt, P. (2017). Cardiac magnetic resonance imaging derived quantification of myocardial ischemia and scar improves risk stratification and patient management in stable coronary artery disease. Cardiology Journal, 24(3), 293-304. doi:10.5603/cj.a2017.0036Zemrak, F., & Petersen, S. E. (2011). Late Gadolinium Enhancement CMR Predicts Adverse Cardiovascular Outcomes and Mortality in Patients With Coronary Artery Disease: Systematic Review and Meta-Analysis. Progress in Cardiovascular Diseases, 54(3), 215-229. doi:10.1016/j.pcad.2011.07.003El Aidi, H., Adams, A., Moons, K. G. M., Den Ruijter, H. M., Mali, W. P. T. M., Doevendans, P. A., … Leiner, T. (2014). Cardiac Magnetic Resonance Imaging Findings and the Risk of Cardiovascular Events in Patients With Recent Myocardial Infarction or Suspected or Known Coronary Artery Disease. Journal of the American College of Cardiology, 63(11), 1031-1045. doi:10.1016/j.jacc.2013.11.048Fox, K. A. A., Metra, M., Morais, J., & Atar, D. (2019). The myth of ‘stable’ coronary artery disease. Nature Reviews Cardiology, 17(1), 9-21. doi:10.1038/s41569-019-0233-ySchiele, F., Ecarnot, F., & Chopard, R. (2017). Coronary artery disease: Risk stratification and patient selection for more aggressive secondary prevention. European Journal of Preventive Cardiology, 24(3_suppl), 88-100. doi:10.1177/2047487317706586Fordyce, C. B., Douglas, P. S., Roberts, R. S., Hoffmann, U., Al-Khalidi, H. R., … Patel, M. R. (2017). Identification of Patients With Stable Chest Pain Deriving Minimal Value From Noninvasive Testing. JAMA Cardiology, 2(4), 400. doi:10.1001/jamacardio.2016.5501Papireddy, M. R., Lavie, C. J., Deoker, A., Mamudu, H., & Paul, T. K. (2018). New Algorithm for the Prediction of Cardiovascular Risk in Symptomatic Adults with Stable Chest Pain. Current Cardiology Reports, 20(5). doi:10.1007/s11886-018-0973-