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Six-Year Prognostic Value of Microvascular Obstruction After Reperfused ST-Elevation Myocardial Infarction as Assessed by Contrast-Enhanced Cardiovascular Magnetic Resonance

Although recent studies showed the prognostic value of cardiac magnetic resonance (CMR) parameters especially microvascular obstruction (MO) after reperfused ST-elevation myocardial infarction (STEMI), a study assessing their prognostic significance for long-term follow-up is missing so far. The obj... Full description

Journal Title: The American journal of cardiology 2015, Vol.116 (7), p.1022-1027
Main Author: Regenfus, Matthias, MD
Other Authors: Schlundt, Christian, MD , Krähner, Robert, MD , Schönegger, Carolin, MD , Adler, Werner, MD , Ludwig, Josef, MD , Daniel, Werner G., MD , Schmid, Michael, MD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: United States: Elsevier Inc
ID: ISSN: 0002-9149
Link: https://www.ncbi.nlm.nih.gov/pubmed/26260397
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title: Six-Year Prognostic Value of Microvascular Obstruction After Reperfused ST-Elevation Myocardial Infarction as Assessed by Contrast-Enhanced Cardiovascular Magnetic Resonance
format: Article
creator:
  • Regenfus, Matthias, MD
  • Schlundt, Christian, MD
  • Krähner, Robert, MD
  • Schönegger, Carolin, MD
  • Adler, Werner, MD
  • Ludwig, Josef, MD
  • Daniel, Werner G., MD
  • Schmid, Michael, MD
subjects:
  • Abridged Index Medicus
  • Analysis
  • Cardiology
  • Cardiovascular
  • Cardiovascular disease
  • Confidence intervals
  • Contrast Media
  • Coronary Circulation - physiology
  • Coronary Occlusion - diagnosis
  • Coronary Occlusion - epidemiology
  • Coronary Occlusion - etiology
  • Diagnosis
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Gadolinium DTPA
  • Germany - epidemiology
  • Heart attack
  • Heart attacks
  • Heart failure
  • Humans
  • Magnetic Resonance Imaging, Cine - methods
  • Male
  • Medical informatics
  • Medical prognosis
  • Microcirculation
  • Middle Aged
  • Multivariate analysis
  • Myocardial Infarction - complications
  • Myocardial Infarction - diagnosis
  • Myocardial Infarction - therapy
  • Myocardial Reperfusion - methods
  • Patients
  • Percutaneous Coronary Intervention - methods
  • Prognosis
  • Retrospective Studies
  • Risk Assessment - methods
  • Scanners
  • Studies
  • Time Factors
ispartof: The American journal of cardiology, 2015, Vol.116 (7), p.1022-1027
description: Although recent studies showed the prognostic value of cardiac magnetic resonance (CMR) parameters especially microvascular obstruction (MO) after reperfused ST-elevation myocardial infarction (STEMI), a study assessing their prognostic significance for long-term follow-up is missing so far. The objective of this study was to determine the prognostic impact of MO on long-term prognosis after reperfused first STEMI in a setting allocating CMR-assessed parameters to hard clinical events only. In 249 patients, CMR was performed after reperfused STEMI, and hereby, left ventricular ejection fraction (LVEF), infarct size (IS), and the amount of MO were quantified. Follow-up (median 6.0 years) was obtained regarding occurrence of major adverse cardiac events (MACE). MACE occurred more often in patients showing presence of MO (MO vs no MO: n = 61 [54%] vs n = 12 [9%], p
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titleSix-Year Prognostic Value of Microvascular Obstruction After Reperfused ST-Elevation Myocardial Infarction as Assessed by Contrast-Enhanced Cardiovascular Magnetic Resonance
creatorRegenfus, Matthias, MD ; Schlundt, Christian, MD ; Krähner, Robert, MD ; Schönegger, Carolin, MD ; Adler, Werner, MD ; Ludwig, Josef, MD ; Daniel, Werner G., MD ; Schmid, Michael, MD
creatorcontribRegenfus, Matthias, MD ; Schlundt, Christian, MD ; Krähner, Robert, MD ; Schönegger, Carolin, MD ; Adler, Werner, MD ; Ludwig, Josef, MD ; Daniel, Werner G., MD ; Schmid, Michael, MD
descriptionAlthough recent studies showed the prognostic value of cardiac magnetic resonance (CMR) parameters especially microvascular obstruction (MO) after reperfused ST-elevation myocardial infarction (STEMI), a study assessing their prognostic significance for long-term follow-up is missing so far. The objective of this study was to determine the prognostic impact of MO on long-term prognosis after reperfused first STEMI in a setting allocating CMR-assessed parameters to hard clinical events only. In 249 patients, CMR was performed after reperfused STEMI, and hereby, left ventricular ejection fraction (LVEF), infarct size (IS), and the amount of MO were quantified. Follow-up (median 6.0 years) was obtained regarding occurrence of major adverse cardiac events (MACE). MACE occurred more often in patients showing presence of MO (MO vs no MO: n = 61 [54%] vs n = 12 [9%], p <0.0001). By multivariate analysis, the extent of MO remained the strongest predictor (p <0.001) for occurrence of MACE and provided incremental prognostic value over clinical variables and LVEF (p = 0.028, c-index increase from 0.723 to 0.817). In conclusion, CMR-assessed MO proves predictive for assessment of 6-year prognosis in patients after reperfused first STEMI and provides incremental prognostic information over clinical variables and LVEF in a setting based on hard end points.
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subjectAbridged Index Medicus ; Analysis ; Cardiology ; Cardiovascular ; Cardiovascular disease ; Confidence intervals ; Contrast Media ; Coronary Circulation - physiology ; Coronary Occlusion - diagnosis ; Coronary Occlusion - epidemiology ; Coronary Occlusion - etiology ; Diagnosis ; Electrocardiography ; Female ; Follow-Up Studies ; Gadolinium DTPA ; Germany - epidemiology ; Heart attack ; Heart attacks ; Heart failure ; Humans ; Magnetic Resonance Imaging, Cine - methods ; Male ; Medical informatics ; Medical prognosis ; Microcirculation ; Middle Aged ; Multivariate analysis ; Myocardial Infarction - complications ; Myocardial Infarction - diagnosis ; Myocardial Infarction - therapy ; Myocardial Reperfusion - methods ; Patients ; Percutaneous Coronary Intervention - methods ; Prognosis ; Retrospective Studies ; Risk Assessment - methods ; Scanners ; Studies ; Time Factors
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6Daniel, Werner G., MD
7Schmid, Michael, MD
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0Six-Year Prognostic Value of Microvascular Obstruction After Reperfused ST-Elevation Myocardial Infarction as Assessed by Contrast-Enhanced Cardiovascular Magnetic Resonance
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descriptionAlthough recent studies showed the prognostic value of cardiac magnetic resonance (CMR) parameters especially microvascular obstruction (MO) after reperfused ST-elevation myocardial infarction (STEMI), a study assessing their prognostic significance for long-term follow-up is missing so far. The objective of this study was to determine the prognostic impact of MO on long-term prognosis after reperfused first STEMI in a setting allocating CMR-assessed parameters to hard clinical events only. In 249 patients, CMR was performed after reperfused STEMI, and hereby, left ventricular ejection fraction (LVEF), infarct size (IS), and the amount of MO were quantified. Follow-up (median 6.0 years) was obtained regarding occurrence of major adverse cardiac events (MACE). MACE occurred more often in patients showing presence of MO (MO vs no MO: n = 61 [54%] vs n = 12 [9%], p <0.0001). By multivariate analysis, the extent of MO remained the strongest predictor (p <0.001) for occurrence of MACE and provided incremental prognostic value over clinical variables and LVEF (p = 0.028, c-index increase from 0.723 to 0.817). In conclusion, CMR-assessed MO proves predictive for assessment of 6-year prognosis in patients after reperfused first STEMI and provides incremental prognostic information over clinical variables and LVEF in a setting based on hard end points.
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15Gadolinium DTPA
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24Medical prognosis
25Microcirculation
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30Myocardial Infarction - therapy
31Myocardial Reperfusion - methods
32Patients
33Percutaneous Coronary Intervention - methods
34Prognosis
35Retrospective Studies
36Risk Assessment - methods
37Scanners
38Studies
39Time Factors
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titleSix-Year Prognostic Value of Microvascular Obstruction After Reperfused ST-Elevation Myocardial Infarction as Assessed by Contrast-Enhanced Cardiovascular Magnetic Resonance
authorRegenfus, Matthias, MD ; Schlundt, Christian, MD ; Krähner, Robert, MD ; Schönegger, Carolin, MD ; Adler, Werner, MD ; Ludwig, Josef, MD ; Daniel, Werner G., MD ; Schmid, Michael, MD
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1Analysis
2Cardiology
3Cardiovascular
4Cardiovascular disease
5Confidence intervals
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atitleSix-Year Prognostic Value of Microvascular Obstruction After Reperfused ST-Elevation Myocardial Infarction as Assessed by Contrast-Enhanced Cardiovascular Magnetic Resonance
jtitleThe American journal of cardiology
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pages1022-1027
issn0002-9149
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abstractAlthough recent studies showed the prognostic value of cardiac magnetic resonance (CMR) parameters especially microvascular obstruction (MO) after reperfused ST-elevation myocardial infarction (STEMI), a study assessing their prognostic significance for long-term follow-up is missing so far. The objective of this study was to determine the prognostic impact of MO on long-term prognosis after reperfused first STEMI in a setting allocating CMR-assessed parameters to hard clinical events only. In 249 patients, CMR was performed after reperfused STEMI, and hereby, left ventricular ejection fraction (LVEF), infarct size (IS), and the amount of MO were quantified. Follow-up (median 6.0 years) was obtained regarding occurrence of major adverse cardiac events (MACE). MACE occurred more often in patients showing presence of MO (MO vs no MO: n = 61 [54%] vs n = 12 [9%], p <0.0001). By multivariate analysis, the extent of MO remained the strongest predictor (p <0.001) for occurrence of MACE and provided incremental prognostic value over clinical variables and LVEF (p = 0.028, c-index increase from 0.723 to 0.817). In conclusion, CMR-assessed MO proves predictive for assessment of 6-year prognosis in patients after reperfused first STEMI and provides incremental prognostic information over clinical variables and LVEF in a setting based on hard end points.
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pmid26260397
doi10.1016/j.amjcard.2015.06.034