Introduction
Materials and methods
Study population and procedures
Cardiovascular magnetic resonance imaging
Laboratory analysis
Statistical analysis
Results
Baseline characteristics
Characteristics | Median (IQR) or n (%), n = 271 |
---|---|
Age, years | 58 (49–66) |
Sex, % female | 58 (21.4) |
Body mass index, kg/m² | 26.6 (24.4–29.4) |
Weight, kg | 83 (75–95) |
Height, cm | 178 (170–184) |
Race/ethnicity, % Caucasian | 257 (94.8) |
Hypertension, % | 75 (27.7) |
Dyslipidemia, % | 168 (62.0) |
Current smoking, % | 139 (51.3) |
Stroke, % | 1 (0.4) |
Previous PCI, % | 4 (1.5) |
Systolic blood pressure, mmHg | 132 (119–146) |
Diastolic blood pressure, mmHg | 83 (74–95) |
Heart rate, beats/min | 74 (64–84) |
Ischemia time, min | 155 (105–240) |
Single vessel disease, % | 195 (72.0) |
Infarct-related artery, % | |
LAD | 111 (40.9) |
LCX | 46 (17.0) |
RCA | 114 (42.1) |
Infarct-related artery TIMI flow pre-PCI, % | |
0 | 153 (56.5) |
1 | 21 (7.8) |
2 | 47 (17.3) |
3 | 50 (18.4) |
Infarct-related artery TIMI flow post-PCI, % | |
2 | 17 (6.3) |
3 | 254 (93.7) |
Myocardial blush grade, % | |
0 | 5 (1.9) |
1 | 19 (7.0) |
2 | 57 (21.2) |
3 | 188 (69.9) |
Peak CK-MB, U/L | 163 (76–328) |
AUC CK-MB, U/L s 10−8
| 0.103 (0.044–1.86) |
Peak CK, U/L | 1420 (680–3110) |
AUC CK, U/L s 10−8
| 1.02 (0.45–2.16) |
Peak Troponin T, ng/L | 49 (22–146) |
AUC Troponin T, ng/L s 10−5
| 1.35 (0.48–2.65) |
NT-proBNP, ng/L | 80 (38–188) |
NT-proBNP at 2 weeks, ng/L | 555 (212–1150) |
NT-proBNP at 6–8 weeks, ng/L | 287 (126–631) |
eGFR, mL/min | 96 (86–103) |
Glucose, mmol/L | 8.2 (6.9–9.5) |
HbA1c, % | 5.8 (5.6–6.0) |
LV structural characteristics
Study cohort n = 271 CMR parameter | (mean ± SD) | Correlation with infarct size (Pearson’s rho) | p | % above P95 or below P5 |
---|---|---|---|---|
LVMi (g/m2) | 50.4 ± 10.7 | 0.26 | <0.001 | 17.2 |
LVEDVi (mL/m2) | 96.1 ± 20.2 | 0.55 | <0.001 | 46.4 |
LVESVi (mL/m2) | 45.3 ± 17.1 | 0.70 | <0.001 | 82.4 |
EDWT (mm) | 5.91 ± 0.85 | – | 0.94 | – |
ESWT (mm) | 9.36 ± 1.34 | – | 0.36 | – |
LVEF (%) | 53.9 ± 8.5 | −0.72 | <0.001 | 79.4 |
Infarct size (% LVM) | 9.0 ± 7.9 | – | – | 87.8 |
Univariate analysis
Factor | LVEDVi | LVESVi | LVMi | EDWT | ESWT | |||||
---|---|---|---|---|---|---|---|---|---|---|
β | p | β | p | β | p | β | p | β | p | |
Age | −0.14 | 0.02 | −0.06 | 0.29 | 0.00 | 0.96 | 0.12 | 0.052 | 0.12 | 0.053 |
Female sex | −0.13 | 0.03 | −0.10 | 0.11 | −0.24 | <0.001 | −0.28 | <0.001 | −0.23 | <0.001 |
Body surface area | 0.08 | 0.17 | 0.04 | 0.46 | 0.11 | 0.07 | 0.32 | <0.001 | 0.28 | <0.001 |
Weight | 0.08 | 0.18 | 0.02 | 0.69 | 0.09 | 0.13 | 0.29 | <0.001 | 0.29 | <0.001 |
Height | 0.12 | 0.047 | 0.08 | 0.17 | 0.17 | 0.005 | 0.26 | <0.001 | 0.24 | <0.001 |
Hypertension | −0.01 | 0.87 | −0.01 | 0.82 | 0.13 | 0.04 | 0.20 | 0.002 | 0.14 | 0.03 |
Dyslipidemia | 0.07 | 0.27 | 0.10 | 0.11 | −0.04 | 0.47 | −0.03 | 0.61 | −0.05 | 0.40 |
Current smoking | −0.04 | 0.47 | −0.03 | 0.58 | 0.04 | 0.49 | 0.04 | 0.51 | 0.04 | 0.53 |
Previous PCI | 0.02 | 0.72 | 0.02 | 0.70 | 0.01 | 0.83 | 0.06 | 0.33 | 0.05 | 0.44 |
Systolic blood pressure | 0.06 | 0.32 | 0.02 | 0.68 | 0.16 | 0.011 | 0.21 | 0.001 | 0.23 | <0.001 |
Diastolic blood pressure | 0.13 | 0.03 | 0.10 | 0.095 | 0.21 | <0.001 | 0.19 | 0.003 | 0.23 | <0.001 |
Heart rate | 0.01 | 0.88 | 0.06 | 0.34 | 0.13 | 0.03 | 0.21 | 0.001 | 0.18 | 0.004 |
Ischemia time | 0.00 | 0.97 | 0.04 | 0.50 | 0.04 | 0.56 | −0.02 | 0.71 | −0.01 | 0.89 |
Factor | LVEDVi | LVESVi | LVMi | EDWT | ESWT | |||||
---|---|---|---|---|---|---|---|---|---|---|
β | p | β | p | β | p | β | p | β | p | |
Single vessel disease | 0.00 | 0.97 | −0.03 | 0.60 | −0.03 | 0.67 | 0.01 | 0.89 | 0.01 | 0.89 |
Infarct-related artery | 0.02 | <0.001 | 0.06 | 0.003 | 0.26 | |||||
LCX | −0.01 | 0.93 | 0.00 | 0.95 | 0.00 | 0.95 | −0.10 | 0.15 | −0.10 | 0.17 |
RCA | −0.17 | 0.01 | −0.23 | <0.001 | −0.15 | 0.03 | −0.23 | 0.001 | −0.10 | 0.17 |
Infarct-related TIMI flow pre-PCI | <0.001 | <0.001 | 0.02 | 0.33 | 0.57 | |||||
TIMI 1 | −0.02 | 0.74 | −0.02 | 0.77 | 0.09 | 0.15 | 0.11 | 0.08 | 0.07 | 0.30 |
TIMI 2 | −0.19 | 0.002 | −0.19 | 0.002 | −0.06 | 0.37 | 0.03 | 0.60 | 0.00 | 0.93 |
TIMI 3 | −0.28 | <0.001 | −0.25 | <0.001 | −0.15 | 0.02 | −0.01 | 0.86 | −0.05 | 0.43 |
Infarct-related TIMI 3 post-PCI | −0.08 | 0.18 | −0.09 | 0.12 | −0.02 | 0.74 | 0.02 | 0.75 | −0.03 | 0.60 |
Myocardial blush grade | 0.08 | 0.03 | 0.31 | 0.99 | 0.70 | |||||
MBG 1 | 0.08 | 0.52 | 0.08 | 0.52 | 0.05 | 0.72 | −0.02 | 0.87 | −0.13 | 0.32 |
MBG 2 | −0.11 | 0.55 | −0.09 | 0.64 | −0.13 | 0.50 | −0.04 | 0.84 | −0.23 | 0.24 |
MBG 3 | −0.13 | 0.52 | −0.17 | 0.41 | −0.09 | 0.66 | −0.06 | 0.79 | −0.22 | 0.29 |
Peak CK-MB | 0.50 | <0.001 | 0.64 | <0.001 | 0.24 | <0.001 | 0.07 | 0.25 | −0.01 | 0.90 |
AUC CK-MB | 0.49 | <0.001 | 0.62 | <0.001 | 0.26 | <0.001 | 0.10 | 0.12 | 0.02 | 0.70 |
Peak CK | 0.51 | <0.001 | 0.64 | <0.001 | 0.24 | <0.001 | 0.07 | 0.14 | 0.00 | 0.97 |
AUC CK | 0.51 | <0.001 | 0.62 | <0.001 | 0.26 | <0.001 | 0.10 | 0.24 | 0.02 | 0.81 |
Peak Troponin T | 0.51 | <0.001 | 0.64 | <0.001 | 0.27 | <0.001 | 0.10 | 0.11 | 0.02 | 0.76 |
AUC Troponin T | 0.51 | <0.001 | 0.62 | <0.001 | 0.32 | <0.001 | 0.15 | 0.02 | 0.08 | 0.23 |
NT-proBNP | 0.24 | <0.001 | 0.23 | <0.001 | 0.13 | <0.001 | 0.20 | 0.001 | 0.20 | 0.002 |
NT-proBNP at 2 weeks | 0.42 | <0.001 | 0.49 | <0.001 | 0.24 | <0.001 | 0.27 | <0.001 | 0.20 | 0.002 |
NT-proBNP at 6–8 weeks | 0.51 | <0.001 | 0.61 | <0.001 | 0.19 | <0.001 | 0.27 | <0.001 | 0.18 | 0.007 |
eGFR | 0.15 | 0.014 | 0.10 | 0.11 | −0.01 | 0.89 | −0.12 | 0.06 | −0.10 | 0.10 |
Glucose | 0.14 | 0.02 | 0.14 | 0.03 | 0.11 | 0.08 | 0.11 | 0.095 | 0.11 | 0.09 |
HbA1c | −0.08 | 0.21 | −0.08 | 0.17 | 0.06 | 0.29 | 0.18 | 0.004 | 0.19 | 0.002 |
Multivariable analysis
Std. β | p-value | |
---|---|---|
LVEDVi (R2 = 0.49) | ||
Age | −0.30 | <0.001 |
Female sex | −0.16 | 0.001 |
Heart rate during CMR | −0.19 | <0.001 |
AUC Troponin T | 0.28 | <0.001 |
NT-proBNP at 6–8 weeks | 0.47 | <0.001 |
LVESVi (R2 = 0.58) | ||
Age | −0.22 | <0.001 |
Female sex | −0.14 | 0.001 |
Peak Troponin T | 0.42 | <0.001 |
NT-proBNP at 6–8 weeks | 0.45 | <0.001 |
LVMi (R2 = 0.43) | ||
Age | −0.16 | 0.002 |
Female sex | −0.38 | <0.001 |
Hypertension at baseline | 0.16 | 0.008 |
Systolic blood pressure | 0.16 | 0.003 |
NT-proBNP at 2 weeks | 0.58 | <0.001 |
EDWT (R2 = 0.45) | ||
Age | 0.15 | 0.022 |
Female sex | −0.22 | <0.001 |
Body surface area | 0.41 | <0.001 |
Heart rate at baseline | 0.14 | 0.007 |
Heart rate during CMR | 0.12 | 0.028 |
Hypertension in medical history | 0.19 | 0.001 |
Current smoking | 0.13 | 0.019 |
NT-proBNP at baseline | 0.12 | 0.036 |
NT-proBNP at 2 weeks | 0.32 | <0.001 |
HbA1C | 0.14 | 0.008 |
ESWT (R2 = 0.35) | ||
Age | 0.21 | <0.001 |
Female sex | −0.18 | 0.016 |
Body surface area | 0.33 | <0.001 |
Heart rate during CMR | 0.14 | 0.011 |
Diastolic blood pressure | 0.19 | 0.001 |
Current smoking | 0.13 | 0.037 |
NT-proBNP at baseline | 0.14 | 0.034 |
NT-proBNP at 2 weeks | 0.21 | 0.002 |
HbA1c | 0.16 | 0.006 |