title: Predictors of acute myocardial infarct size in STEMI patients receiving thrombolytic therapy: A delayed contrast enhanced cardiac MRI study.
abstract: BACKGROUND
  Delayed contrast enhanced Cardiac MRI has been accepted as a standard tool worldwide for determination of infarcted myocardium and viability. Infarct size as determined by cardiac MRI has important therapeutic and prognostic information.
  
  
  METHODS
  Twenty six STEMI patients who had received thrombolytic therapy were subjected to cardiac MRI assessment at 5-7 day of admission. Base line variables of the study population were compared with the acute infarct size as determined by the Cardiac MRI.
  
  
  RESULTS
  The mean acute infarct size in our study population was 27.2 ± 17.4% of LV. We found through univariate analysis that final infarct size was dependent on time to thrombolysis (p = 0.04), Status of Thrombolysis (p = 0.01), smoking status (p = 0.02), location of infarct (p < 0.00001), presence of microvascular obstruction (p = 0.01) and viability status (p = 0.0004). Thus, larger acute infarct size was seen in delayed time to thrombolysis, failed status of thrombolysis, smokers, anterior location of the infarct, presence of microvascular obstruction and non viable myocardial status.
  
  
  CONCLUSIONS
  Infarct size as determined by Cardiac MRI has been shown to carry important therapeutic and prognostic information. We have tried to evaluate predictors of acute infarct on cardiac MRI in STEMI patients during their initial hospital stay. Knowing the predictors of acute infarct size can help in early intervention and provide prognostic information for future cardiac events.
authors.affiliation: Senior Resident, Department of Radiodiagnosis, IGMC, Shimla, India. Electronic address: drvikasbhatia@gmail.com.
authors.forename: Vikas
authors.initials: V
authors.lastname: Bhatia
authors.affiliation: Professor and Head, Department of Radiodiagnosis, IGMC, Shimla, India.
authors.forename: R G
authors.initials: RG
authors.lastname: Sood
authors.affiliation: Professor, Department of Radiodiagnosis, IGMC, Shimla, India.
authors.forename: D S
authors.initials: DS
authors.lastname: Dhiman
authors.affiliation: Associate Professor, Department of Radiodiagnosis, IGMC, Shimla, India.
authors.forename: Ashwani
authors.initials: A
authors.lastname: Tomar
authors.affiliation: Assistant Professor, Department of Cardiology, IGMC, Shimla, India.
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Asotra
authors.affiliation: Professor and Head, Department of Cardiology, IGMC, Shimla, India.
authors.forename: P C
authors.initials: PC
authors.lastname: Negi
authors.affiliation: Senior Resident, Department of Cardiology, IGMC, Shimla, India.
authors.forename: Prashant
authors.initials: P
authors.lastname: Panda
mesh_terms: D003287:Contrast Media / Q000494:pharmacology*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis* / Q000188:drug therapy; D012720:Severity of Illness Index; D015912:Thrombolytic Therapy / Q000379:methods*
chemical_list: D003287:Contrast Media; D005343:Fibrinolytic Agents
keywords: Acute infarct size; Cardiac MRI; STEMI; Thrombolysis; Viability