Myocardial Infarct Size by CMR in Clinical Cardioprotection Studies
Why the study?
Do cardioprotective therapies reduce myocardial infarct size measured by CMR in patients with STEMI treated with primary PCI?
Population
10,570 patients from 62 RCTs with ST-segment elevation myocardial infarction treated with primary…
Comparison
Cardioprotective strategies aimed at reducing… vs Control arms of the included RCTs.
Design
Systematic_review
Follow-up
Acute (3-5 days) and follow-up (up to 6 months)
Authors
Discussion
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Implication
Supplies benchmark control MI sizes for STEMI cardioprotection RCTs; extends prior work by advocating standardized CMR protocols to reduce heterogeneity.
Structured PICO
Do cardioprotective therapies reduce myocardial infarct size measured by CMR in patients with STEMI treated with primary PCI?
P
Population
10,570 patients from 62 RCTs with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PPCI) presenting within 12 hours of symptom onset.
I
Intervention
Cardioprotective strategies aimed at reducing myocardial infarct size.
C
Comparator
Control arms of the included RCTs.
O
Outcome
Myocardial infarct (MI) size, expressed as a percentage of left ventricular (LV) volume or mass (%LV).surrogate
Significant heterogeneity exists in RCT design using CMR to quantify MI size in STEMI patients, prompting recommendations for standardized CMR acquisition and analysis to optimize future cardioprotection trials.
Limitations
- Included only RCTs
- Concentrated only on MI size and did not evaluate the use of myocardial salvage index (MSI) due to lack of consensus on area at risk methodologies
- Did not assess the definition of microvascular obstruction (MVO) in the included RCTs
Cite This Study
Bulluck et al. (2017) studied this question.