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July 1, 2026JACC AsiaOpen Access

Prognostic Value of Persistent Microvascular Obstruction on Follow-Up Cardiac MRI After Reperfused STEMI

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Why the study?

The prognostic value of persistent microvascular obstruction in STEMI patients after percutaneous coronary intervention remained unclear.

Does the presence of persistent microvascular obstruction on follow-up cardiac MRI predict heart failure events in STEMI patients after primary PCI?

Population

504 STEMI patients treated with primary PCI who underwent follow-up CMR at ≥60 days

Comparison

Presence vs absence of persistent microvascular obstruction on follow-up CMR

Design

Retrospective cohort study

Follow-up

Median 64.5 months (IQR: 45.0-79.4)

Authors

PZPengyu ZhouChinese Academy of Medical Sciences & Peking Union Medical CollegeFSFen SaChinese Academy of Medical Sciences & Peking Union Medical CollegeKAKaisaierjiang AisikaierCardiac Imaging

Discussion

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Implication

Persistent-MVO may refine post-STEMI risk stratification beyond standard markers; leaves open its role in guiding therapy.

Structured PICO

Does the presence of persistent microvascular obstruction on follow-up cardiac MRI predict heart failure events in STEMI patients after primary PCI?

P
Population
504 STEMI patients treated with primary PCI who underwent a follow-up cardiac magnetic resonance at ≥60 days after PCI
I
Intervention
Presence of persistent microvascular obstruction (persistent-MVO) on late gadolinium enhancement (LGE) imaging
C
Comparator
Absence of persistent microvascular obstruction
O
Outcome
Composite events of heart failure (HF), including HF-related death, heart transplantation, left ventricular assist device implantation, and HF hospitalizationcomposite

Persistent microvascular obstruction on follow-up cardiac MRI at least 60 days post-PCI is present in 8.7% of STEMI patients and provides incremental prognostic value for heart failure events beyond established risk markers.

Cite This Study

Zhou et al. (2026) studied this question.

synapsesocial.com/papers/6a7e6538b44705ee46856c0dhttps://doi.org/10.1016/j.jacasi.2026.06.014
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