Prognostic Stratification of Patients With ST-Segment-Elevation Myocardial Infarction (PROSPECT): A Cardiac Magnetic Resonance Study.

Détails

ID Serval
serval:BIB_408061E5CA8E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Prognostic Stratification of Patients With ST-Segment-Elevation Myocardial Infarction (PROSPECT): A Cardiac Magnetic Resonance Study.
Périodique
Circulation. Cardiovascular imaging
Auteur(s)
Pontone G., Guaricci A.I., Andreini D., Ferro G., Guglielmo M., Baggiano A., Fusini L., Muscogiuri G., Lorenzoni V., Mushtaq S., Conte E., Annoni A., Formenti A., Mancini M.E., Carità P., Verdecchia M., Pica S., Fazzari F., Cosentino N., Marenzi G., Rabbat M.G., Agostoni P., Bartorelli A.L., Pepi M., Masci P.G.
ISSN
1942-0080 (Electronic)
ISSN-L
1941-9651
Statut éditorial
Publié
Date de publication
11/2017
Peer-reviewed
Oui
Volume
10
Numéro
11
Pages
NA
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Résumé
Cardiac magnetic resonance (CMR) is a robust tool to evaluate left ventricular ejection fraction (LVEF), myocardial salvage index, microvascular obstruction, and myocardial hemorrhage in patients with ST-segment-elevation myocardial infarction. We evaluated the additional prognostic benefit of a CMR score over standard prognostic stratification with global registry of acute coronary events (GRACE) score and transthoracic echocardiography LVEF measurement.
Two hundred nine consecutive patients with ST-segment-elevation myocardial infarction (age, 61.4±11.4 years; 162 men) underwent transthoracic echocardiography and CMR after succesful primary percutaneous coronary intervention. Major adverse cardiac events (MACE) were assessed at a mean follow-up of 2.5±1.2 years. MACE occurred in 24 (12%) patients who at baseline showed higher GRACE risk score (P<0.01), lower LVEF with both transthoracic echocardiography and CMR, lower myocardial salvage index, and higher per-patient myocardial hemorrhage and microvascular obstruction prevalence and amount as compared with patients without MACE (P<0.01). The best cut-off values of transthoracic echocardiography-LVEF, CMR-LVEF, myocardial salvage index, and microvascular obstruction to predict MACE were 46.7%, 37.5%, 0.4, and 2.6% of left ventricular mass, respectively. Accordingly, a weighted CMR score, including the following 4 variables (CMR-LVEF, myocardial salvage index, microvascular obstruction, and myocardial hemorrhage), with a maximum of 17 points was calculated and included in the multivariable analysis showing that only CMR score (hazard ratio, 1.867 per SD increase [1.311-2.658]; P<0.001) was independently associated with MACE with the highest net reclassification improvement as compared to GRACE score and transthoracic echocardiography-LVEF measurement.
CMR score provides incremental prognostic stratification as compared with GRACE score and transthoracic echocardiography-LVEF and may impact the management of patients with ST-segment-elevation myocardial infarction.

Mots-clé
Aged, Chi-Square Distribution, Coronary Angiography, Coronary Circulation, Echocardiography, Female, Hemorrhage/diagnostic imaging, Humans, Magnetic Resonance Imaging, Cine, Male, Microcirculation, Middle Aged, Multivariate Analysis, Percutaneous Coronary Intervention, Predictive Value of Tests, Proportional Hazards Models, Risk Factors, ST Elevation Myocardial Infarction/diagnostic imaging, ST Elevation Myocardial Infarction/physiopathology, ST Elevation Myocardial Infarction/therapy, Stroke Volume, Time Factors, Treatment Outcome, Ventricular Function, Left, ST-segment–elevation myocardial infarction, humans, magnetic resonance, prognosis
Pubmed
Web of science
Open Access
Oui
Création de la notice
23/11/2017 22:17
Dernière modification de la notice
20/08/2019 14:39
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