Transient STEMI was associated with significantly smaller infarct size compared to STEMI (1.4 g vs 13.5 g, P<0.001) and more preserved global LV strain, resembling NSTEMI characteristics.
Cohort (n=407)
Yes
Does transient ST-segment elevation myocardial infarction (TSTEMI) result in different LV function, strain, and infarct characteristics compared to STEMI and NSTEMI?
TSTEMI is associated with more favorable LV function and smaller infarct size compared to STEMI, with cardiac characteristics that more closely resemble NSTEMI.
Absolute Event Rate: 1.4% vs 13.5%
p-value: p=<0.001
AIMS: This study aims to explore cardiovascular magnetic resonance (CMR)-derived left ventricular (LV) function, strain, and infarct size characteristics in patients with transient ST-segment elevation myocardial infarction (TSTEMI) compared to patients with ST-segment and non-ST-segment elevation myocardial infarctions (STEMI and NSTEMI, respectively). METHODS AND RESULTS: In total, 407 patients were enrolled in this multicentre observational prospective cohort study. All patients underwent CMR examination 2-8 days after the index event. CMR cine imaging was performed for functional assessment and late gadolinium enhancement to determine infarct size and identify microvascular obstruction (MVO). TSTEMI patients demonstrated the highest LV ejection fraction and the most preserved global LV strain (longitudinal, circumferential, and radial) across the three groups (overall P ≤ 0.001). The CMR-defined infarction was less frequently observed in TSTEMI than in STEMI patients 77 (65%) vs. 124 (98%), P < 0.001 but was comparable with NSTEMI patients 77 (65%) vs. 66 (70%), P = 0.44. A remarkably smaller infarct size was seen in TSTEMI compared to STEMI patients 1.4 g (0.0-3.9) vs. 13.5 g (5.3-26.8), P < 0.001, whereas infarct size was not significantly different from that in NSTEMI patients 1.4 g (0.0-3.9) vs. 2.1 g (0.0-8.6), P = 0.06. Whilst the presence of MVO was less frequent in TSTEMI compared to STEMI patients 5 (4%) vs. 53 (31%), P < 0.001, no significant difference was seen compared to NSTEMI patients 5 (4%) vs. 5 (5%), P = 0.72. CONCLUSION: TSTEMI yielded favourable cardiac LV function, strain, and infarct-related scar mass compared to STEMI and NSTEMI. LV function and infarct characteristics of TSTEMI tend to be more similar to NSTEMI than STEMI.
Demirkıran et al. (Wed,) conducted a cohort in Transient ST-segment elevation myocardial infarction (TSTEMI) (n=407). Transient ST-segment elevation myocardial infarction (TSTEMI) vs. STEMI and NSTEMI was evaluated on Infarct size (g) (p=<0.001). Transient STEMI was associated with significantly smaller infarct size compared to STEMI (1.4 g vs 13.5 g, P<0.001) and more preserved global LV strain, resembling NSTEMI characteristics.
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