Prognostic value of microvascular obstruction and infarct size, as measured by CMR in STEMI patients

JACC Cardiovasc Imaging. 2014 Sep;7(9):930-9. doi: 10.1016/j.jcmg.2014.05.010.

Abstract

The aim of this study was to evaluate the value of microvascular obstruction (MO) and infarct size as a percentage of left ventricular mass (IS%LV), as measured by contrast-enhanced cardiac magnetic resonance, in predicting major cardiovascular adverse events (MACE) at 2 years in patients with ST-segment elevation myocardial infarction reperfused by primary percutaneous coronary intervention. Individual data from 1,025 patients were entered into the pooled analysis. MO was associated with the occurrence of MACE, defined as a composite of cardiac death, congestive heart failure, and myocardial re-infarction (adjusted hazard ratio: 3.74; 95% confidence interval: 2.21 to 6.34). IS%LV ≥25% was not associated with MACE (adjusted hazard ratio: 0.90; 95% confidence interval: 0.59 to 1.37). The authors conclude that MO is an independent predictor of MACE and cardiac death, whereas IS%LV is not independently associated with MACE.

Keywords: cardiac magnetic resonance; infarct size; microvascular obstruction; myocardial infarction; prognosis.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Coronary Circulation*
  • Female
  • Heart Failure / mortality
  • Heart Failure / physiopathology
  • Heart Ventricles / pathology*
  • Heart Ventricles / physiopathology
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Microcirculation*
  • Middle Aged
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / mortality
  • Myocardial Infarction / pathology
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / therapy
  • Myocardium / pathology*
  • No-Reflow Phenomenon / diagnosis*
  • No-Reflow Phenomenon / pathology
  • No-Reflow Phenomenon / physiopathology
  • Percutaneous Coronary Intervention / adverse effects
  • Predictive Value of Tests
  • Recurrence
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome