title: Assessment of myocardial infarction by cardiac magnetic resonance imaging and long-term mortality.
abstract: BACKGROUND
  Cardiac magnetic resonance imaging provides detailed anatomical information on infarction. However, few studies have investigated the association of these data with mortality after acute myocardial infarction.
  
  
  OBJECTIVE
  To study the association between data regarding infarct size and anatomy, as obtained from cardiac magnetic resonance imaging after acute myocardial infarction, and long-term mortality.
  
  
  METHODS
  A total of 1959 reports of "infarct size" were identified in 7119 cardiac magnetic resonance imaging studies, of which 420 had clinical and laboratory confirmation of previous myocardial infarction. The variables studied were the classic risk factors - left ventricular ejection fraction, categorized ventricular function, and location of acute myocardial infarction. Infarct size and acute myocardial infarction extent and transmurality were analyzed alone and together, using the variable named "MET-AMI". The statistical analysis was carried out using the elastic net regularization, with the Cox model and survival trees.
  
  
  RESULTS
  The mean age was 62.3 ± 12 years, and 77.3% were males. During the mean follow-up of 6.4 ± 2.9 years, there were 76 deaths (18.1%). Serum creatinine, diabetes mellitus and previous myocardial infarction were independently associated with mortality. Age was the main explanatory factor. The cardiac magnetic resonance imaging variables independently associated with mortality were transmurality of acute myocardial infarction (p = 0.047), ventricular dysfunction (p = 0.0005) and infarcted size (p = 0.0005); the latter was the main explanatory variable for ischemic heart disease death. The MET-AMI variable was the most strongly associated with risk of ischemic heart disease death (HR: 16.04; 95%CI: 2.64-97.5; p = 0.003).
  
  
  CONCLUSIONS
  The anatomical data of infarction, obtained from cardiac magnetic resonance imaging after acute myocardial infarction, were independently associated with long-term mortality, especially for ischemic heart disease death.
authors.affiliation: Instituto do Coração Edson Saad, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: João Luiz Fernandes
authors.initials: JL
authors.lastname: Petriz
authors.affiliation: Hospital Barra D'Or, Rio de Janeiro, RJ, Brazil.
authors.forename: Bruno Ferraz de Oliveira
authors.initials: BF
authors.lastname: Gomes
authors.affiliation: Hospital Barra D'Or, Rio de Janeiro, RJ, Brazil.
authors.forename: Braulio Santos
authors.initials: BS
authors.lastname: Rua
authors.affiliation: Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, RJ, Brazil.
authors.forename: Clério Francisco
authors.initials: CF
authors.lastname: Azevedo
authors.affiliation: Instituto do Coração Edson Saad, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Marcelo Souza
authors.initials: MS
authors.lastname: Hadlich
authors.affiliation: Instituto do Coração Edson Saad, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Henrique Thadeu Periard
authors.initials: HT
authors.lastname: Mussi
authors.affiliation: Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, RJ, Brazil.
authors.forename: Gunnar de Cunto
authors.initials: Gde C
authors.lastname: Taets
authors.affiliation: Instituto do Coração Edson Saad, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Emília Matos do
authors.initials: EM
authors.lastname: Nascimento
authors.affiliation: Instituto do Coração Edson Saad, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Basílio de Bragança
authors.initials: Bde B
authors.lastname: Pereira
authors.affiliation: Instituto do Coração Edson Saad, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Nelson Albuquerque de Souza e
authors.initials: NA
authors.lastname: Silva
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D023381:Endpoint Determination; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality* / Q000503:physiopathology; D012720:Severity of Illness Index; D013997:Time Factors; D014652:Vascular Diseases / Q000401:mortality / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology