Introduction
Methods
Study design and endpoint definitions
Cardiac magnetic resonance imaging
Statistical analysis
Results
Baseline characteristics
Characteristic | Total population (n = 224) | No MACE (n = 211, 94%) | MACE (n = 13, 6%) | p value |
---|---|---|---|---|
Age, years | 56 (49–66) | 56 (49–66) | 61 (49–73) | 0.35 |
Female, n (%) | 33 (15) | 30 (14) | 3 (23) | 0.38 |
Body mass index (kg/m2) | 26.2 (24.7–28.4) | 26.2 (24.7–28.6) | 25.8 (23.3–27.2) | 0.17 |
Hypertension, n (%) | 129 (58) | 120 (57) | 9 (69) | 0.39 |
Systolic blood pressure (mmHg) | 127 (114–147) | 127 (113–146) | 135 (121–150) | 0.55 |
Diastolic blood pressure (mmHg) | 80 (70–90) | 80 (70–90) | 83 (75–95) | 0.35 |
Family history for AMI, n (%) | 59 (26) | 56 (27) | 3 (23) | 0.93 |
Current smoker, n (%) | 127 (57) | 118 (56) | 9 (69) | 0.36 |
Hyperlipidemia, n (%) | 142 (63) | 134 (64) | 8 (62) | 0.87 |
Diabetes mellitus, n (%) | 23 (10) | 18 (9) | 5 (39) |
0.001
|
Culprit lesion | 0.36 | |||
RCA | 99 (44) | 94 (45) | 5 (38) | |
LAD | 94 (42) | 86 (41) | 8 (62) | |
LCX | 28 (13) | 28 (13) | 0 (0) | |
RI | 3 (1) | 3 (1) | 0 (0) | |
Time from symptom onset to PPCI (min) | 206 (135–389) | 206 (136–389) | 177 (103–494) | 0.38 |
Pre-interventional TIMI flow | 0.49 | |||
0 | 135 (60) | 126 (60) | 9 (69) | |
1 | 34 (15) | 31 (15) | 3 (23) | |
2 | 45 (20) | 44 (21) | 1 (8) | |
3 | 10 (5) | 10 (5) | 0 (0) | |
Post-interventional TIMI flow |
0.002
| |||
0 | 7 (3) | 6 (3) | 1 (8) | |
1 | 3 (1) | 2 (1) | 1 (8) | |
2 | 19 (9) | 15 (7) | 4 (31) | |
3 | 195 (87) | 188 (89) | 7 (54) |
Baseline and follow-up CMR findings
CMR parameter | Total population (n = 224) | No MACE (n = 211, 94%) | MACE (n = 13, 6%) | p value |
---|---|---|---|---|
LVEF baseline (%) | 54 (47-60) | 54 (47–60) | 42 (37-55) |
0.02
|
LVEDV baseline (ml) | 151 (125-167) | 151 (127-166) | 128 (102-171) | 0.32 |
LVEDVi baseline (ml/m2) | 74.7 (66.7-82.6) | 74.8 (67.4-82.5) | 66.7 (58.1-85.3) | 0.42 |
LVESV baseline (ml) | 69 (51-83) | 68 (52-83) | 79 (46-109) | 0.39 |
LVESVi baseline (ml/m2) | 34.9 (27.3-42.0) | 34.8 (27.3-41.4) | 47.6 (27.1-52.7) | 0.23 |
LVMM baseline (g) | 134 (115-156) | 135 (116-155) | 132 (94-154) | 0.38 |
LVMMi baseline (g/m2) | 67.9 (60.1-76.8) | 68.0 (60.4-77.0) | 66.0 (55.7-76.5) | 0.34 |
CO baseline (ml/min) | 5.4 (4.6-6.2) | 5.4 (4.6-6.2) | 4.8 (4.1-5.8) | 0.09 |
CI baseline (ml/min/m2) | 2.8 (2.4-3.1) | 2.7 (2.4-3.1) | 2.7 (2.1-2.9) | 0.16 |
IS baseline (% of LVMM) | 15 (7-26) | 15 (7-25) | 21 (15-41) | 0.12 |
MVO, n (%) | 118 (53) | 107 (51) | 11 (85) |
0.01
|
LVEF follow-up (%) | 59 (51-65) | 59 (51-65) | 51 (40-61) |
0.04
|
LVEDV follow-up (ml) | 149 (127-168) | 148 (127-167) | 153 (117-194) | 0.64 |
LVEDVi follow-up (ml/m2) | 75.0 (65.4-85.9) | 74.8 (65.2-85.5) | 82.6 (65.9-98.4) | 0.20 |
LVESV follow-up (ml) | 60 (49-79) | 60 (49-78) | 89 (44-107) | 0.14 |
LVESVi follow-up (ml/m2) | 31.3 (23.9-39.6) | 31.3 (23.9-38.6) | 41.6 (23.6-58.7) | 0.07 |
LVMM follow-up (g) | 128 (114-148) | 128 (114-48) | 127 (99-159) | 0.99 |
LVMMi follow-up (g/m2) | 68.9 (58.3-73.4) | 64.7 (58.3-72.8) | 69.1 (58.2-78.7) | 0.52 |
CO follow-up (ml/min) | 5.3 (4.5-5.9) | 5.3 (4.5-5.9) | 4.8 (4.4-6.7) | 0.72 |
CI follow-up (ml/min/m2) | 2.7 (2.3-3.0) | 2.7 (2.3-3.0) | 2.6 (2.4-3.2) | 0.88 |
%∆LVEF (%) | 8 (-1–18) | 8 (-1–18) | 9 (-6–32) | 0.66 |
%∆LVEDV (%) | 2 (- 9-12) | 1 (- 9-10) | 13 (5-25) |
0.002
|
%∆LVESV (%) | - 6 (- 21-9) | -6 (-21–9) | 6 (-9–23) | 0.06 |
%∆LVMM (%) | -4 (-14–5) | - 5 (- 14-4) | 6 (-7–22) |
0.02
|
%∆CO (%) | -4 (-15–10) | -4 (-14–5) | 4 (-11–29) | 0.11 |
Health outcome
Association between CMR parameters of remodeling and clinical outcome
HR (95%CI) | p value | |
---|---|---|
%∆LVEDV (%) | 1.04 (1.02–1.07) |
0.003
|
%∆LVEDV ≥ 10% | 8.68 (2.39–31.56) |
0.001
|
%∆LVEDV ≥ 12% | 4.11 (1.38–12.23) |
0.01
|
%∆LVEDV ≥ 20% | 3.17 (0.98–10.28) | 0.06 |
%∆LVESV (%) | 1.01 (0.99–1.03) | 0.13 |
%∆LVESV ≥ 6% | 3.02 (1.02–8.99) |
0.05
|
%∆LVESV ≥ 12% | 2.38 (0.78–7.28) | 0.13 |
%∆LVESV ≥ 15% | 2.84 (0.93–8.69) | 0.07 |
%∆LVMM (%) | 1.05 (1.01–1.08) |
0.01
|
%∆LVMM ≥ 5% | 4.79 (1.57–14.65) |
0.01
|
LVEF baseline | 0.94 (0.89–0.98) |
0.01
|
LVEF baseline < 47% | 4.67 (1.53–14.27) |
0.01
|
LVEF follow-up | 0.94 (0.90–0.98) |
0.01
|
LVEF follow-up < 52% | 4.23 (1.39–12.94) |
0.01
|
MVO | 9.88 (1.28–76.56) |
0.03
|
Diabetes mellitus | 5.92 (1.94–18.10) |
0.002
|
Post-interventional TIMI flow | 0.52 (0.32–0.84) |
0.01
|
HR (95%CI) | p value | |
---|---|---|
Model A | ||
%∆LVEDV ≥ 10% | 8.59 (2.04–36.20) |
0.003
|
%∆LVESV ≥ 6% | 1.02 (0.30–3.44) | 0.97 |
Model B | ||
%∆LVEDV ≥ 10% | 7.53 (2.06–27.52) |
0.002
|
%∆LVMM ≥ 5% | 3.89 (1.27–11.97) |
0.02
|
Model C | ||
%∆LVEDV ≥ 10% | 7.22 (1.96–26.54) |
0.003
|
LVEF baseline < 47% | 3.52 (1.14–10.87) |
0.03
|
Model D | ||
%∆LVEDV ≥ 10% | 6.67 (1.75–25.35) |
0.005
|
LVEF follow-up < 52% | 2.50 (0.78–7.94) | 0.12 |
Model E | ||
%∆LVEDV ≥ 10% | 5.92 (1.59–22.06) |
0.01
|
MVO | 6.93 (0.88–54.44) | 0.07 |
Model F | ||
%∆LVEDV ≥ 10% | 8.39 (2.31–30.51) |
0.001
|
Diabetes mellitus | 5.64 (1.84–17.27) |
0.002
|
Model G | ||
%∆LVEDV ≥ 10% | 11.12 (2.92–42.41) |
< 0.001
|
Post-interventional TIMI flow | 0.41 (0.24–0.70) |
0.001
|