Acute myocardial infarction: safety of cardiac MR imaging after percutaneous revascularization with stents.
OBJECTIVE
To retrospectively determine the safety of cardiac magnetic resonance (MR) imaging performed early (<14 days) after coronary stent implantation in patients with acute myocardial infarction (AMI).


METHODS
This HIPPA-compliant study was approved by the institutional review board; the informed consent requirement was waived. Consecutive patients with AMI who underwent cardiac MR imaging (study group) shortly after stent implantation (median, 3 days) were compared with control subjects who did not undergo MR imaging and were matched for clinical factors and angiographic extent of coronary disease. A 1.5-T MR imager was used to evaluate cine function, perfusion, and viability. Rates of death, nonfatal myocardial infarction, or revascularization 30 days and 6 months after stent implantation were compared with chi(2) analysis.


RESULTS
The study group consisted of 66 patients (median age, 56 years; 17 women) with 97 stents, 38 (39%) of which were drug eluting. The control group included 124 patients (median age, 58 years; 23% women) with 197 stents, 21 (10.7%) of which were drug eluting. There was no significant (P = .13) difference in the combined end point of death, nonfatal myocardial infarction, or revascularization between the study (2.0% [95% confidence interval: 0.0%, 4.5%]) and control (6.5% [95% confidence interval: 1.6%, 11.3%]) groups at 30-day follow-up. The event-free survival rate at 6-month follow-up was 91% in the study group and 83.7% in the control group (P = .18). Considering the end points separately, there was no difference in the event rate at 30-day or 6-month follow-up between groups. No adverse cardiovascular events occurred in patients with drug-eluting stents who underwent MR imaging.


CONCLUSIONS
Cardiac MR imaging performed shortly after AMI and percutaneous revascularization with bare metal or drug-eluting stents appears safe. The risk of adverse cardiovascular events is low and similar to that in patients who do not undergo MR imaging.
Patel
Manesh R
MR
Cardiovascular Magnetic Resonance Center and Clinical Research Institute, Duke University Medical Center, 2400 Pratt St, Durham, NC 27705, USA. patel017@mc.duke.edu
Albert
Timothy S E
TS
Kandzari
David E
DE
Honeycutt
Emily F
EF
Shaw
Linda K
LK
Sketch
Michael H
MH
Elliott
Michael D
MD
Judd
Robert M
RM
Kim
Raymond J
RJ
D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D009204:Myocardial Revascularization / Q000379:methods*; D012189:Retrospective Studies; D015607:Stents