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

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• 作者：Matthias Regenfus ; MD^a ; ^{dres.regenfus@t-online.de" class="auth_mail" title="E-mail the corresponding author} ; Christian Schlundt ; MD^a ; Robert Krä ; hner ; MD^a ; Carolin Schö ; negger ; MD^a ; Werner Adler ; MD^b ; Josef Ludwig ; MD^a ; Werner G. Daniel ; MD^a ; Michael Schmid ; MD^a
• 刊名：The American Journal of Cardiology
• 出版年：2015
• 出版时间：1 October 2015
• 年：2015
• 卷：116
• 期：7
• 页码：1022-1027
• 全文大小：429 K

文摘

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 <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.