Volume 15 Supplement 1

Abstracts of the 16th Annual SCMR Scientific Sessions

Open Access

Impact of CMR parameters on clinical outcome after STEMI: data from a large multi-center study

  • Suzanne de Waha1,
  • Ingo Eitel1,
  • Georg Fuernau1,
  • Philipp Lurz1,
  • Jochen Wöhrle2,
  • Henning Suenkel1,
  • Josefine Meissner1,
  • Sebastian Kerber3,
  • Bernward Lauer4,
  • Matthias Pauschinger5,
  • Ralf Birkemeyer6,
  • Christoph Axthelm7,
  • Rainer Zimmermann8,
  • Steffen Desch1,
  • Matthias Gutberlet9,
  • Gerhard Schuler1 and
  • Holger Thiele1
Journal of Cardiovascular Magnetic Resonance201315(Suppl 1):O93

https://doi.org/10.1186/1532-429X-15-S1-O93

Published: 30 January 2013

Background

Data on the prognostic value of cardiac magnetic resonance imaging (CMR) parameters in patients with ST-elevation myocardial infarction (STEMI) are limited due to analysis of single-center cohorts and small study sample sizes. Aim of the current study was thus to investigate the impact of infarct size, microvascular obstruction (MO) and myocardial salvage index (MSI) on clinical outcome in a large cohort of STEMI patients derived from a multi-center study.

Methods

STEMI patients (n=795) reperfused by primary percutaneous coronary intervention (PCI) within 12 hours after symptom onset underwent CMR in 8 centers in Germany. CMR was performed at day 1 to 4 after the index event. Infarct size and microvascular obstruction (MO) were measured 15 minutes after gadolinium injection. T2-weighted and contrast-enhanced CMR were used to calculate the MSI. The primary endpoint was defined as a composite of death, non-fatal myocardial reinfarction and congestive heart failure (MACE). Clinical follow-up was conducted after 12 months.

Results

Infarct size, MO and MSI were significantly associated with MACE in univariable Cox regression analysis (all p<0.01). In multivariable Cox regression analysis including TIMI-risk score, TIMI-flow pre- and post-PCI, ST-segment resolution, left ventricular ejection fraction, as well as infarct size, MO and MSI, infarct size was independently associated with the occurrence of MACE (HR 1.03, 95% CI 1.01-1.04, p=0.02).

Conclusions

In this largest multi-center cohort of patients with STEMI undergoing CMR reported so far, infarct size as well as MO and MSI were significantly associated with the occurrence of death, non-fatal myocardial reinfarction and congestive heart failure. Infarct size was identified as an independent predictor for adverse clinical outcome after STEMI even after adjustment for traditional outcome markers.

Funding

None.

Authors’ Affiliations

(1)
Department of Internal Medicine/Cardiology, University of Leipzig - Heart Center
(2)
University of Ulm
(3)
Herz- und Gefäss-Klinik Bad Neustadt
(4)
Zentralklinik Bad Berka
(5)
Klinikum Nürnberg
(6)
Schwarzwald-Baar Klinikum Villingen-Schwenningen
(7)
(8)
(9)
Department of Diagnostic and Interventional Radiology, University of Leipzig - Heart Center

Copyright

© de Waha et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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