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November 1, 2022Age and AgeingOpen Access

Adding CMR to baseline echo models improves MACE prediction in older STEMI patients.

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Why the study?

Older patients with STEMI represent a very high-risk population, but data on the prognostic value of early CMR in this scenario are scarce.

Does early cardiac magnetic resonance improve prognostic prediction of major adverse cardiac events in older patients (>70 years) with STEMI treated with percutaneous intervention?

Population

247 STEMI patients over 70 years of age treated with percutaneous intervention

Comparison

Addition of CMR parameters vs baseline and echocardiographic characteristics alone

Design

Multicenter prospective registry

Follow-up

4.8-year mean

Key result

Adding cardiac magnetic resonance data to baseline and echocardiographic models significantly improved the prediction of major adverse cardiac events in older STEMI patients (C-statistic 0.759 vs 0.685; P<0.001).

Authors

AGA Gabaldon-PerezVMVíctor Marcos‐GarcésJGJosé Gavara

Discussion

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Member takes

Overview

May aid risk stratification in older STEMI patients; leaves open need for prospective outcome trials.

Study Design

Type

Cohort (n=247)

Multicenter

Yes

Structured PICO

Does early cardiac magnetic resonance improve prognostic prediction of major adverse cardiac events in older patients (>70 years) with STEMI treated with percutaneous intervention?

P
Population
247 STEMI patients over 70 years of age treated with percutaneous intervention
I
Intervention
Prognostic assessment using cardiac magnetic resonance (CMR) early after STEMI
C
Comparator
Prognostic assessment using baseline and echocardiographic characteristics (including GRACE score)
O
Outcome
First major adverse cardiac events (MACE), defined as all-cause death and re-admissions for acute heart failurecomposite

Main Result

Effect estimate: C-statistic 0.759 (95% CI 0.694-0.824)

p-value: p=<0.001

Early cardiac magnetic resonance provides valuable prognostic information that significantly improves the prediction of major adverse cardiac events in older patients with STEMI.

Limitations

  • The Older-STEMI-CMR score should be externally validated.

Cite This Study

Gabaldon-Perez et al. (2022) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=247). Cardiac magnetic resonance (CMR) vs. Baseline and echocardiographic characteristics model was evaluated on Major adverse cardiac events (MACE) (C-statistic 0.759, 95% CI 0.694-0.824, p=<0.001). Adding cardiac magnetic resonance data to baseline and echocardiographic models significantly improved the prediction of major adverse cardiac events in older STEMI patients (C-statistic 0.759 vs 0.685; P<0.001).

synapsesocial.com/papers/6a169f5df96f07bf256b3f82https://doi.org/10.1093/ageing/afac248
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prognostic value of cardiac magnetic resonance in elderly patients soon after ST-segment elevation myocardial infarction2022 · 1 citations
  2. 2Cardiac magnetic resonance imaging improves prognostic stratification of patients with ST-elevation myocardial infarction and preserved ejection fraction2021 · 12 citations
  3. 3Risk score for early risk prediction by cardiac magnetic resonance after acute myocardial infarction2021 · 21 citations
  4. 4Prognosis after ST-elevation myocardial infarction: a study on cardiac magnetic resonance imaging versus clinical routine2014 · 56 citations
  5. 5Early or deferred cardiovascular magnetic resonance after ST-segment-elevation myocardial infarction for effective risk stratification2019 · 20 citations