What question did this study set out to answer?

This study aims to determine the prognostic value of early cardiac magnetic resonance in elderly patients following ST-segment elevation myocardial infarction.

June 25, 2026European Heart JournalOpen Access

Early CMR improves MACE prediction over baseline clinical and echo models alone.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: ST-segment elevation myocardial infarction (STEMI) (n=247). Intervention: Early (1-week) cardiac magnetic resonance (CMR) vs. Baseline and echocardiographic characteristics. Primary outcome: Major adverse cardiac events (MACE) (C-statistic 0.759, 95% CI 0.694-0.824, p=<0.001).

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Why the study?

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

Does early cardiac magnetic resonance improve the prediction of major adverse cardiac events in elderly patients after STEMI?

Population

247 patients over 70 years of age discharged for a first STEMI treated with percutaneous intervention

Comparison

Additional prognostic value of CMR variables compared to baseline and echocardiographic characteristics

Design

Prospective multicenter registry

Follow-up

4.8-year mean

Key result

Early cardiac magnetic resonance significantly improved the prediction of major adverse cardiac events when added to baseline and echocardiographic models (C-statistic 0.759 vs 0.685; P<0.001).

Authors

VGV Marcos Garces AGA Gabaldon-Perez JGJosé Gavara

Discussion

Member takes

Overview

Early CMR may enhance post-MI risk stratification beyond echocardiography; extends existing models with incremental prognostic value.

Key Points

This study aims to determine the prognostic value of early cardiac magnetic resonance in elderly patients following ST-segment elevation myocardial infarction.
Registry of 247 patients over 70 years of age discharged after first STEMI treated with percutaneous intervention.
Collected data on CMR-derived left ventricular ejection fraction, infarct size, and microvascular obstruction.
Assessed prognostic power of CMR using adjusted C-statistic, net reclassification index, and integrated discrimination improvement index.
During 4.8 years median follow-up, 26.7% experienced major adverse cardiac events.
Higher GRACE score, lower CMR-LVEF, and more extensive MVO predicted MACE occurrence with specific hazard ratios.
CMR data significantly improved MACE prediction, with best cut-offs for GRACE score and LVEF highlighting increased risk.

Study Design

Type

Cohort (n=247)

Multicenter

Yes

Structured PICO

Does early cardiac magnetic resonance improve the prediction of major adverse cardiac events in elderly patients after STEMI?

Population

247 patients over 70 years of age discharged for a first STEMI treated with percutaneous intervention, followed for a mean of 4.8 years.

Exposure

Early (1-week) cardiac magnetic resonance (CMR) assessing left ventricular ejection fraction, infarct size, and microvascular obstruction

Comparator

Baseline clinical and echocardiographic characteristics alone

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 CMR provides significant incremental prognostic value over clinical and echocardiographic parameters for predicting MACE in elderly patients following STEMI.

Cite This Study

Garces et al. (2022) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=247). Early (1-week) cardiac magnetic resonance (CMR) vs. Baseline and echocardiographic characteristics was evaluated on Major adverse cardiac events (MACE) (C-statistic 0.759, 95% CI 0.694-0.824, p=<0.001). Early cardiac magnetic resonance significantly improved the prediction of major adverse cardiac events when added to baseline and echocardiographic models (C-statistic 0.759 vs 0.685; P<0.001).

synapsesocial.com/papers/6a3cf294b20054bd7fc0be11 https://doi.org/10.1093/eurheartj/ehac544.2552

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June 25, 2026European Heart JournalOpen Access

Early CMR improves MACE prediction over baseline clinical and echo models alone.

View Full Paper

Ask AI

Bookmark

Why the study?

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

Does early cardiac magnetic resonance improve the prediction of major adverse cardiac events in elderly patients after STEMI?

Population

247 patients over 70 years of age discharged for a first STEMI treated with percutaneous intervention

Comparison

Additional prognostic value of CMR variables compared to baseline and echocardiographic characteristics

Design

Prospective multicenter registry

Follow-up

4.8-year mean

Key result

Early cardiac magnetic resonance significantly improved the prediction of major adverse cardiac events when added to baseline and echocardiographic models (C-statistic 0.759 vs 0.685; P<0.001).

Authors

VGV Marcos Garces AGA Gabaldon-Perez JGJosé Gavara

Discussion

Member takes

Overview

Early CMR may enhance post-MI risk stratification beyond echocardiography; extends existing models with incremental prognostic value.

Key Points

This study aims to determine the prognostic value of early cardiac magnetic resonance in elderly patients following ST-segment elevation myocardial infarction.
Registry of 247 patients over 70 years of age discharged after first STEMI treated with percutaneous intervention.
Collected data on CMR-derived left ventricular ejection fraction, infarct size, and microvascular obstruction.
Assessed prognostic power of CMR using adjusted C-statistic, net reclassification index, and integrated discrimination improvement index.
During 4.8 years median follow-up, 26.7% experienced major adverse cardiac events.
Higher GRACE score, lower CMR-LVEF, and more extensive MVO predicted MACE occurrence with specific hazard ratios.
CMR data significantly improved MACE prediction, with best cut-offs for GRACE score and LVEF highlighting increased risk.

Study Design

Type

Cohort (n=247)

Multicenter

Yes

Structured PICO

Does early cardiac magnetic resonance improve the prediction of major adverse cardiac events in elderly patients after STEMI?

Population

247 patients over 70 years of age discharged for a first STEMI treated with percutaneous intervention, followed for a mean of 4.8 years.

Exposure

Early (1-week) cardiac magnetic resonance (CMR) assessing left ventricular ejection fraction, infarct size, and microvascular obstruction

Comparator

Baseline clinical and echocardiographic characteristics alone

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 CMR provides significant incremental prognostic value over clinical and echocardiographic parameters for predicting MACE in elderly patients following STEMI.

Cite This Study

synapsesocial.com/papers/6a3cf294b20054bd7fc0be11 https://doi.org/10.1093/eurheartj/ehac544.2552

Also Consider

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