Portal de investigación
Risk score for early risk prediction by cardiac magnetic resonance after acute myocardial infarction.
Fecha de publicación:
Fecha Ahead of Print:
Autores de INCLIVA
Participantes ajenos a INCLIVA
- Perez, Nerea
- Gavara, Jose
- Lopez-Lereu, Maria P
- Monmeneu, Jose V
- Moratal, David
- Valente, Filipa
- Lorenzatti, Daniel
- Ortiz-Perez, Jose T
- Rodriguez-Palomares, Jose F
Grupos y Plataformas de I+D+i
Abstract
BACKGROUND: Cardiac magnetic resonance (CMR) performed early after ST-segment elevation myocardial infarction (STEMI) can improve major adverse cardiac event (MACE) risk prediction. We aimed to create a simple clinical-CMR risk score for early MACE risk stratification in STEMI patients. METHODS: We performed a multicenter prospective registry of reperfused STEMI patients (n = 1118) in whom early (1-week) CMR-derived left ventricular ejection fraction (LVEF), infarct size and microvascular obstruction (MVO) were quantified. MACE was defined as a combined clinical endpoint of cardiovascular (CV) death, non-fatal myocardial infarction (NF-MI) or re-admission for acute decompensated heart failure (HF). RESULTS: During a median follow-up of 5.52 [2.63-7.44] years, 216 first MACE (58 CV deaths, 71 NF-MI and 87 HF) were registered. Mean age was 59.3 ± 12.3 years and most patients (82.8%) were male. Based on the four variables independently associated with MACE, we computed an 8-point risk score: time to reperfusion >4.15 h (1 point), GRACE risk score > 155 (3 points), CMR-LVEF <40% (3 points), and MVO >1.5 segments (1 point). This score permitted MACE risk stratification: MACE per 100 person-years was 1.96 in the low-risk category (0-2 points), 5.44 in the intermediate-risk category (3-5 points), and 19.7 in the high-risk category (6-8 points): p < 0.001 in multivariable Cox survival analysis. CONCLUSIONS: A novel risk score including clinical (time to reperfusion >4.15 h and GRACE risk score > 155) and CMR (LVEF <40% and MVO >1.5 segments) variables allows for simple and straightforward MACE risk stratification early after STEMI. External validation should confirm the applicability of the risk score.
Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.
Datos de la publicación
- ISSN/ISSNe:
- 0167-5273, 1874-1754
- Tipo:
- Article
- Páginas:
- 150-154
- PubMed:
- 34826497
INTERNATIONAL JOURNAL OF CARDIOLOGY ELSEVIER IRELAND LTD
Citas Recibidas en Web of Science: 12
Documentos
Filiaciones
Keywords
- Cardiac magnetic resonance; Left ventricular ejection fraction; Microvascular obstruction; Myocardial infarction; Prognosis; Risk
Financiación
Proyectos y Estudios Clínicos
Resolution of microvascular obstruction after myocardial infarction. A multidisciplinary approach to assess the structural and clinical consequences and to evaluate new therapeutic options.
Investigador Principal: VICENT BODÍ PERIS
PI20/00637 . INSTITUTO SALUD CARLOS III . 2021
AYUDAS JUAN DE LA CIERVA INCORPORACIÓN 2020
Investigador Principal: ANA MARÍA ORTEGA GUTIÉRREZ
IJC2020-045308-I . MINISTERIO DE CIENCIA E INNOVACIÓN . 2022
Cita
Risk score for early risk prediction by cardiac magnetic resonance after acute myocardial infarction. Marcos V, Perez N, Gavara J, Lopez MP, Monmeneu JV, Rios C, de Dios E et al. INTERNATIONAL JOURNAL OF CARDIOLOGY. 2022 febrero 15. 349150-154. DOI:10.1016/j.ijcard.2021.11.050. PMID:34826497.
