Portal de investigación
Prognostic value of cardiac magnetic resonance early after ST-segment elevation myocardial infarction in older patients.
Fecha de publicación:
Autores de INCLIVA
Participantes ajenos a INCLIVA
- Gabaldón-Pérez A
- Gavara J
- López-Lereu MP
- Monmeneu JV
- Moratal D
- Valente F
- Lorenzatti D
- Ortiz-Pérez JT
- Rodríguez-Palomares JF
Grupos y Plataformas de I+D+i
Abstract
BACKGROUND: older patients with ST-segment elevation myocardial infarction (STEMI) represent a very high-risk population. Data on the prognostic value of cardiac magnetic resonance (CMR) in this scenario are scarce. METHODS: the registry comprised 247 STEMI patients over 70 years of age treated with percutaneous intervention and included in a multicenter registry. Baseline characteristics, echocardiographic parameters and CMR-derived left ventricular ejection fraction (LVEF, %), infarct size (% of left ventricular mass) and microvascular obstruction (MVO, number of segments) were prospectively collected. The additional prognostic power of CMR was assessed using adjusted C-statistic, net reclassification index (NRI) and integrated discrimination improvement index (IDI). RESULTS: during a 4.8-year mean follow-up, the number of first major adverse cardiac events (MACE) was 66 (26.7%): 27 all-cause deaths and 39 re-admissions for acute heart failure. Predictors of MACE were GRACE score (HR 1.03 [1.02-1.04], P < 0.001), CMR-LVEF (HR 0.97 [0.95-0.99] per percent increase, P = 0.006) and MVO (HR 1.24 [1.09-1.4] per segment, P = 0.001). Adding CMR data significantly improved MACE prediction compared to the model with baseline and echocardiographic characteristics (C-statistic 0.759 [0.694-0.824] vs. 0.685 [0.613-0.756], NRI = 0.6, IDI = 0.08, P < 0.001). The best cut-offs for independent variables were GRACE score > 155, LVEF < 40% and MVO = 2 segments. A simple score (0, 1, 2, 3) based on the number of altered factors accurately predicted the MACE per 100 person-years: 0.78, 5.53, 11.51 and 78.79, respectively (P < 0.001). CONCLUSIONS: CMR data contribute valuable prognostic information in older patients submitted to undergo CMR soon after STEMI. The Older-STEMI-CMR score should be externally validated.
© The Author(s) 2022. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Datos de la publicación
- ISSN/ISSNe:
- 0002-0729, 1468-2834
- Tipo:
- Article
- Páginas:
- -
- PubMed:
- 36436010
AGE AND AGEING OXFORD UNIV PRESS
Citas Recibidas en Web of Science: 4
Documentos
- No hay documentos
Filiaciones
Keywords
- cardiac magnetic resonance; myocardial infarction; older patients; older people; prognosis; risk
Financiación
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Cita
Gabaldón A,Marcos V,Gavara J,López MP,Monmeneu JV,Pérez N,Ríos C,De Dios E,Merenciano H,Cànoves J,Racugno P,Bonanad C,Minana G,Núnez J,Moratal D,Chorro FJ,Valente F,Lorenzatti D,Ortiz JT,Rodríguez JF,Bodí V. Prognostic value of cardiac magnetic resonance early after ST-segment elevation myocardial infarction in older patients. Age Ageing. 2022. 51. (11):afac248. IF:6,700. (1).
Prognostic value of cardiac magnetic resonance early after ST-segment elevation myocardial infarction in older patients. Gabaldón A, Marcos V, Gavara J, López MP, Monmeneu JV, Pérez N, Ríos C et al. AGE AND AGEING. 2022 noviembre 02. 51 (11):DOI:10.1093/ageing/afac248. PMID:36436010.
