Contrast-enhanced cardiovascular magnetic resonance in the hyperacute phase of ST-elevation myocardial infarction.
Cardiovascular magnetic resonance (CMR) very early after primary percutaneous coronary intervention (PPCI) may lead to instability or early stent complications. However, CMR in the hyperacute phase of STEMI may improve risk stratification. We investigated feasibility and safety of CMR in the hyperacute phase of STEMI immediately after PPCI. One hundred and twenty eight consecutive patients immediately after PPCI for STEMI. Sixty four underwent CMR <12 h after PPCI versus 64 matched controls. Outcomes were followed over 6 months. CMR in hyperacute STEMI was not associated with in-hospital death, infarct expansion, or urgent revascularization (P = NS). CMR (32 ml gadolinium contrast) immediately after PPCI (180 ml iodine contrast) did not increase nephropathy. CMR did not increase major adverse cardiac events (5 vs. 8%, P = 0.16) or recurrence of angina (6 vs. 8%, P = 0.73) at 6 months. CMR immediately after PPCI is feasible and safe, allowing very early risk stratification in STEMI.
Larose
Eric
E
Département multidisciplinaire de cardiologie, Institut universitaire de cardiologie et de pneumologie de Québec and Faculté de médecine de l'Université Laval, 2725 chemin Ste-Foy, Quebec, QC, Canada. eric.larose@crhl.ulaval.ca
Côté
Julie
J
Rodés-Cabau
Josep
J
Noël
Bernard
B
Barbeau
Gerald
G
Bordeleau
Edith
E
Miró
Santiago
S
Brochu
Bernard
B
Delarochellière
Robert
R
Bertrand
Olivier F
OF
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D016022:Case-Control Studies; D003287:Contrast Media / Q000009:adverse effects; D017023:Coronary Angiography; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D019786:Gadolinium DTPA / Q000009:adverse effects; D006801:Humans; D007472:Iohexol; D053208:Kaplan-Meier Estimate; D019028:Magnetic Resonance Imaging, Cine / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014283:Triiodobenzoic Acids
D003287:Contrast Media; D014283:Triiodobenzoic Acids; D007472:Iohexol; C064925:gadodiamide; C044834:iodixanol; D019786:Gadolinium DTPA