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

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Journal of Cardiovascular Magnetic Resonance201315 (Suppl 1) :O93

  • Published:


  • Percutaneous Coronary Intervention
  • Infarct Size
  • Cardiac Magnetic Resonance
  • Cardiac Magnetic Resonance Imaging
  • Primary Percutaneous Coronary Intervention


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.


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.


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).


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.



Authors’ Affiliations

Department of Internal Medicine/Cardiology, University of Leipzig - Heart Center, Leipzig, Germany
University of Ulm, Ulm, Germany
Herz- und Gefäss-Klinik Bad Neustadt, Bad Neustadt, Germany
Zentralklinik Bad Berka, Bad Berka, Germany
Klinikum Nürnberg, Nürnberg, Germany
Schwarzwald-Baar Klinikum Villingen-Schwenningen, Villingen-Schwenningen, Germany
Klinikum Pirna, Pirna, Germany
Klinikum Pforzheim, Pforzheim, Germany
Department of Diagnostic and Interventional Radiology, University of Leipzig - Heart Center, Leipzig, Germany


© 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 (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.