What question did this study set out to answer?

The research aimed to determine how various cardiac magnetic resonance endpoints affect 10-year outcomes in STEMI patients.

January 10, 2026

Ten-year prognostic impact of cardiac magnetic resonance endpoints in patients with ST-segment elevation myocardial infarction

Key Result

Smaller infarct size and higher myocardial salvage index independently predicted lower all-cause mortality or hospitalization for heart failure over 10 years post-STEMI (HR < 1).

Key Points

The research aimed to determine how various cardiac magnetic resonance endpoints affect 10-year outcomes in STEMI patients.
Performed cardiac magnetic resonance during admission and three months later.
Analyzed infarct size, myocardial salvage index, and left ventricular ejection fraction.
Utilized adjusted Cox regression models to link CMR endpoints to outcomes.
Smaller infarct size and transmurality predicted lower all-cause mortality and hospitalization.
Higher myocardial salvage index and left ventricular ejection fraction were associated with better outcomes.
Microvascular obstruction was not linked to the composite outcome.

Structured PICO

Do acute and 3-month CMR endpoints predict 10-year all-cause mortality or heart failure hospitalization in patients with STEMI?

Population

811 patients with ST-segment elevation myocardial infarction (STEMI)

Intervention

Cardiac magnetic resonance (CMR) performed during admission and after three months to assess acute and three-month infarct size (IS), myocardial salvage index (MSI), left ventricular ejection fraction (LVEF), microvascular obstruction (MVO) and transmurality

Outcome

Composite of all-cause mortality or hospitalization for heart failure 10 years after STEMIcomposite

CMR-derived infarct size, myocardial salvage index, LVEF, and transmurality measured acutely and at 3 months independently predict 10-year mortality and heart failure hospitalization in STEMI patients.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Aims The study aimed to investigate the importance of infarct size (IS), microvascular obstruction (MVO), and myocardial salvage index (MSI) on the 10-year outcome in patients with ST-segment elevation myocardial infarction (STEMI). Methods and Results Patients with STEMI had cardiac magnetic resonance (CMR) performed during admission and after three months to assess acute and three-month IS, MSI, left ventricular ejection fraction (LVEF), MVO and transmurality. Adjusted Cox regression models were used to investigate the association between CMR endpoints and all-cause mortality or hospitalization for heart failure 10 years after STEMI. A total of 811 patients had either acute or follow-up CMR performed. During median follow-up of 10.9 years, 173 (21%) patients died or were hospitalized for heart failure. Acute IS (adjusted hazard ratio (HR): 1.02; 95%-confidence interval (CI): 1.01-1.04; p=0.005), three-month IS (adjusted HR: 1.04; 95%-CI: 1.02-1.06; p0.001), acute MSI (adjusted HR: 0.99; 95%-CI: 0.98-1.00; p=0.007), three-month MSI (adjusted HR: 0.99; 95%-CI: 0.98-1.00; p=0.004), acute LVEF (adjusted HR: 0.97; 95%-CI: 0.95-0.99; p=0.001), three-month LVEF (adjusted HR: 0.95; 95%-CI: 0.93-0.97; p0.001), acute transmurality (adjusted HR: 1.01; 95%-CI: 1.00-1.02; p=0.024), and three-month transmurality (adjusted HR: 1.01; 95%-CI: 1.00-1.02; p=0.003) were all significant predictors of the composite outcome. MVO was not associated with the composite outcome (adjusted HR: 1.04; 95%-CI: 0.98-1.09; p=0.20). Conclusion Smaller IS, smaller transmurality, higher MSI, and higher LVEF measured acutely and three months after STEMI were independently associated with lower all-cause mortality and/or hospitalization for heart failure within 10 years after STEMI, whereas MVO was not. Clinical trial registration: Registered with ClinicalTrials.gov (identifiers: NCT01435408 and NCT01960933)

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