title: Prognostic value of microvascular obstruction and infarct size, as measured by CMR in STEMI patients.
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.
authors.affiliation: Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Radiology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Matthijs
authors.initials: M
authors.lastname: van Kranenburg
authors.affiliation: Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Michael
authors.initials: M
authors.lastname: Magro
authors.affiliation: Medical Clinic II-Cardiology/Angiology/Intensive Care Medicine, University Hospital Schleswig-Holstein, University of Lübeck, Lübeck, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Thiele
authors.affiliation: Department of Cardiology, Heart Center Bad Segeberg, Bad Segeberg, Germany.
authors.forename: Suzanne
authors.initials: S
authors.lastname: de Waha
authors.affiliation: Medical Clinic II-Cardiology/Angiology/Intensive Care Medicine, University Hospital Schleswig-Holstein, University of Lübeck, Lübeck, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Eitel
authors.affiliation: Departments of Nuclear Medicine and Cardiology, Centre Georges-François Leclerc, Dijon, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Cochet
authors.affiliation: Department of Cardiology, University Hospital of Dijon, Dijon, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Cottin
authors.affiliation: Department of Cardiology, Division of Medicine, Oslo University Hospital Ulleval, and Institute for Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Dan
authors.initials: D
authors.lastname: Atar
authors.affiliation: Department of Cardiology, University Hospital Basel, Basel, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Buser
authors.affiliation: Departments of Medicine and Radiology, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Edwin
authors.initials: E
authors.lastname: Wu
authors.affiliation: Departments of Medicine and Radiology, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Daniel
authors.initials: D
authors.lastname: Lee
authors.affiliation: Department of Cardiology, University of Valencia, Valencia, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Bodi
authors.affiliation: Department of Cardiology, University Clinic of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Gert
authors.initials: G
authors.lastname: Klug
authors.affiliation: Department of Cardiology, University Clinic of Internal Medicine II, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Metzler
authors.affiliation: Department of Cardiology, Amsterdam Medical Center, Amsterdam, the Netherlands.
authors.forename: Ronak
authors.initials: R
authors.lastname: Delewi
authors.affiliation: Department of Internal Medicine, University of Ulm, Ulm, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Bernhardt
authors.affiliation: Department of Internal Medicine, University of Ulm, Ulm, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rottbauer
authors.affiliation: Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Eric
authors.initials: E
authors.lastname: Boersma
authors.affiliation: Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Felix
authors.initials: F
authors.lastname: Zijlstra
authors.affiliation: Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Radiology, Erasmus Medical Center, Rotterdam, the Netherlands. Electronic address: r.vangeuns@erasmusmc.nl.
authors.forename: Robert-Jan
authors.initials: RJ
authors.lastname: van Geuns
mesh_terms: D000368:Aged; D003326:Coronary Circulation; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000503:physiopathology; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D009206:Myocardium / Q000473:pathology*; D054318:No-Reflow Phenomenon / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D011237:Predictive Value of Tests; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: cardiac magnetic resonance; infarct size; microvascular obstruction; myocardial infarction; prognosis