Higher Canadian Cardiovascular Society stages of myocardial tissue injury were independently associated with major adverse cardiovascular events at 12 months (HR 5.86; 95% CI 2.26-15.20; p<0.001).
Cohort (n=1,109)
Yes
Does the Canadian Cardiovascular Society (CCS) myocardial tissue injury classification predict MACE and mortality in patients with STEMI treated by PCI?
The Canadian Cardiovascular Society (CCS) classification of myocardial tissue injury using CMR provides moderate to good predictive value for 12-month MACE and mortality in STEMI patients post-PCI.
Hazard Ratio: 5.86 (95% CI 2.26–15.2)
p-value: p=<0.001
Abstract Background Myocardial infarction (MI) involves progressive tissue damage beyond necrosis. The recently proposed Canadian Cardiovascular Society (CCS) classification defines this damage in four stages, potentially optimizing personalized risk stratification and advancing research on cardioprotective treatments. The baseline associations and prognostic implications of this classification remain to be explored. Objectives To compare clinical characteristics across CCS stages and to validate their prognostic implications in patients with ST-elevation myocardial infarction (STEMI) treated by percutaneous coronary intervention (PCI). Methods We analysed 1,109 STEMI patients included in three prospective studies. Cardiac magnetic resonance (CMR) imaging was performed 3 (interquartile range 2-5) days after MI and patients were classified as follows: stage 1 (aborted MI), stage 2 (MI with necrosis and absence of microvascular injury), stage 3 (MI with necrosis and microvascular obstruction) and stage 4 (MI with necrosis and intramyocardial haemorrhage). Results This analysis revealed distinct patterns of clinical presentation, biomarker profiles and cardiac function at different CCS stages. There were differences in adverse clinical event rates and mortality between CCS stages (major adverse cardiovascular event MACE: 0.7%, 3.4%, 3.1%, 15.7%, p0.001 and mortality: 0.7%, 1.7%, 0.9%, 6.3%, p0.001). The CCS stage had a moderate to good predictive value for MACE and mortality (AUC 0.74 95% CI: 0.68-0.80, p0.001 and AUC 0.71 95% CI: 0.61-0.80, p0.001) at 12 months, respectively. CCS stages were independently associated with MACE in multivariable Cox regression (HR: 5.86 95% CI, 2.26-15.20, p0.001). Conclusion This study describes clinical characteristics across CCS stages and provides insights into the prognostic implications of the different stages of tissue injury.
Lechner et al. (Thu,) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=1,109). Canadian Cardiovascular Society (CCS) classification stages of myocardial tissue injury vs. Across different CCS stages was evaluated on Major adverse cardiovascular event (MACE) (HR 5.86, 95% CI 2.26-15.20, p=<0.001). Higher Canadian Cardiovascular Society stages of myocardial tissue injury were independently associated with major adverse cardiovascular events at 12 months (HR 5.86; 95% CI 2.26-15.20; p<0.001).