Impact of early vs. late microvascular obstruction assessed by magnetic resonance imaging on long-term outcome after ST-elevation myocardial infarction: a comparison with traditional prognostic markers
Why the study?
Does late microvascular obstruction assessed by MRI better predict clinical outcomes compared to early microvascular obstruction in STEMI patients?
Population
STEMI patients reperfused by primary angioplasty < 12 h after symptom onset (n = 438)
Comparison
Assessment of late microvascular obstruction by… vs Assessment of early MO by MRI and traditional…
Design
Cohort
Follow-up
median 19 months
Authors
Discussion
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Member takes
Implication
Late MO on MRI may refine post-STEMI risk stratification; leaves open superiority to early MO and impact on management.
Structured PICO
Does late microvascular obstruction assessed by MRI better predict clinical outcomes compared to early microvascular obstruction in STEMI patients?
P
Population
STEMI patients reperfused by primary angioplasty < 12 h after symptom onset (n = 438)
I
Intervention
Assessment of late microvascular obstruction (MO) by MRI (15 min after gadolinium injection)
C
Comparator
Assessment of early MO by MRI (1 min after gadolinium injection) and traditional prognostic markers
O
Outcome
Composite of death, non-fatal myocardial re-infarction, and congestive heart failurecomposite
Late microvascular obstruction assessed by MRI is a strong independent prognosticator for adverse clinical outcomes after STEMI, providing incremental value over traditional markers and early MO.
Cite This Study
Waha et al. (2010) studied this question.