Author + information
- Matthijs van Kranenburg,
- Michael Magro,
- Suzanne de Waha,
- Holger Thiele,
- Vicente Bodi Peris,
- Alexandre Cochet,
- Gert Klug,
- Edwin Wu,
- Dan Atar,
- Peter Bernhardt,
- Ronak Delewi,
- Eric Boersma,
- Felix Zijlstra and
- Robert-Jan van Geuns
Aim of this study is to evaluate the prognostic value of the presence of microvascular obstruction (MVO) and infarct size, measured by cardiovascular magnetic resonance imaging (CMR), in STEMI patients treated with primary percutaneous coronary intervention (pPCI). No multicenter/multivendor observational study has previously been reported.
A multicenter, multivendor meta-analysis of individual patient data was set up. Data from 9 centers (8 studies) from 7 countries were pooled. The primary outcome was major adverse cardiovascular event (MACE) defined as any of the following events: all cause death, myocardial reinfarction and congestive heart failure.
In this preliminary analysis from 5 studies, 819 STEMI patients (age mean, 60.4 ± 12.9), treated with pPCI underwent a CMR scan 4 days (IQR 2;6) after the event. MVO measured with late gadolinium enhancement (MVO-LGE), was present in 484 patients (59.2%) and absent in 334 patients (40.8%). Median follow-up after CMR was 11 (IQR 6; 23) months. MACE occurred in 123 patients. Age (Exp(B) = 1.017, P = 0.021), diabetes (Exp(B) = 1.671, P = 0.012), prior myocardial infarction (Exp(B) = 2.048, P = 0.012), prior PCI (Exp(B) = 2.243, P = 0.003), TIMI-flow (0, 1 and 2, Exp(B) = 1.869, P = 0.017), MVO-LGE (Exp(B) = 3.654, P = 0.001), infarct size %LV (Exp(B)= 1.029, P = 0.001) and left ventricular ejection fraction (Exp(B) = 0.877, P = 0.007), were univariable predictors for the occurrence of MACE. Multivariable Cox regression revealed an independent relation between MVO-LGE (Exp(B) = 2.695, 95.0% Cl for Exp(B), LL: 1.593, UL: 4.559, P = 0.001) and MACE adjusted for previous mentioned variables. IS%LV did not remain a predictor for major adverse cardiovascular events in the multivariable analysis (Exp(B) = 1.010, P = 0.186).
MVO measured with CMR is an independent predictor for MACE in patients with STEMI treated with pPCI.
Oral Contributions South, Room 104
Saturday, March 09, 2013, 8:30 a.m.-8:45 a.m.
Session Title: Cardiac MRI in CAD: Acute and Chronic Applications, Prognosis and Safety
Abstract Category: 19. Imaging: MRI
Presentation Number: 907-5
- 2013 American College of Cardiology Foundation