Sub-acute cardiac magnetic resonance to predict irreversible reduction in left ventricular ejection fraction after ST-segment elevation myocardial infarction: A DANAMI-3 sub-study
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Sub-acute cardiac magnetic resonance to predict irreversible reduction in left ventricular ejection fraction after ST-segment elevation myocardial infarction : A DANAMI-3 sub-study. / Alzuhairi, Karam Sadoon; Lønborg, Jacob; Ahtarovski, Kiril Aleksov; Nepper-Christensen, Lars; Kyhl, Kasper; Lassen, Jens F.; Sørensen, Rikke; Joshi, Francis; Ghotbi, Adam Ali; Schoos, Mikkel; Goransson, Christoffer; Bertelsen, Litten; Helqvist, Steffen; Holmvang, Lene; Jørgensen, Erik; Pedersen, Frants; Tilsted, Hans Henrik; Høfsten, Dan; Køber, Lars; Kelbæk, Henning; Vejlstrup, Niels; Engstrøm, Thomas.
I: International Journal of Cardiology, Bind 301, 02.2020, s. 215-219.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Sub-acute cardiac magnetic resonance to predict irreversible reduction in left ventricular ejection fraction after ST-segment elevation myocardial infarction
T2 - A DANAMI-3 sub-study
AU - Alzuhairi, Karam Sadoon
AU - Lønborg, Jacob
AU - Ahtarovski, Kiril Aleksov
AU - Nepper-Christensen, Lars
AU - Kyhl, Kasper
AU - Lassen, Jens F.
AU - Sørensen, Rikke
AU - Joshi, Francis
AU - Ghotbi, Adam Ali
AU - Schoos, Mikkel
AU - Goransson, Christoffer
AU - Bertelsen, Litten
AU - Helqvist, Steffen
AU - Holmvang, Lene
AU - Jørgensen, Erik
AU - Pedersen, Frants
AU - Tilsted, Hans Henrik
AU - Høfsten, Dan
AU - Køber, Lars
AU - Kelbæk, Henning
AU - Vejlstrup, Niels
AU - Engstrøm, Thomas
PY - 2020/2
Y1 - 2020/2
N2 - Aims: To predict irreversible reduction in left ventricular ejection fraction (LVEF) during admission for ST-segment elevation myocardial infarction (STEMI) using cardiac magnetic resonance (CMR) in addition to classical clinical parameters. Irreversible reduction in LVEF is an important prognostic factor after STEMI which necessitates medical therapy and implantation of prophylactic implantable cardioverter defibrillator (ICD). Methods and results: A post-hoc analysis of DANAMI-3 trial program (Third DANish Study of Optimal Acute Treatment of Patients With ST-elevation Myocardial Infarction) which recruited 649 patients who had CMR performed during index hospitalization and after 3 months. Patients were divided into two groups according to CMR-LVEF at 3 months: Group 1 with LVEF≤35% and Group 2 with LVEF>35%. Group 1 included 15 patients (2.3%) while Group 2 included 634 patients (97.7%). A multivariate analysis showed that: Killip class >1 (OR 7.39; CI:1.47–36.21, P = 0.01), symptom onset-to-wire ≥6 h (OR 7.19; CI 1.07–50.91, P = 0.04), LVEF≤35% using index echocardiography (OR 7.11; CI: 1.27–47.43, P = 0.03), and infarct size ≥40% of LV on index CMR (OR 42.62; CI:7.83–328.29, P < 0.001) independently correlated with a final LVEF≤35%. Clinical models consisted of these parameters could identify 7 out of 15 patients in Group 1 with 100% positive predictive value. Conclusion: Together with other clinical measurements, the assessment of infarct size using late Gadolinium enhancement by CMR during hospitalization is a strong predictor of irreversible reduction in CMR_LVEF ≤35. That could potentially, after validation with future research, aids the selection and treatment of high-risk patients after STEMI, including implantation of prophylactic ICD during index hospitalization.
AB - Aims: To predict irreversible reduction in left ventricular ejection fraction (LVEF) during admission for ST-segment elevation myocardial infarction (STEMI) using cardiac magnetic resonance (CMR) in addition to classical clinical parameters. Irreversible reduction in LVEF is an important prognostic factor after STEMI which necessitates medical therapy and implantation of prophylactic implantable cardioverter defibrillator (ICD). Methods and results: A post-hoc analysis of DANAMI-3 trial program (Third DANish Study of Optimal Acute Treatment of Patients With ST-elevation Myocardial Infarction) which recruited 649 patients who had CMR performed during index hospitalization and after 3 months. Patients were divided into two groups according to CMR-LVEF at 3 months: Group 1 with LVEF≤35% and Group 2 with LVEF>35%. Group 1 included 15 patients (2.3%) while Group 2 included 634 patients (97.7%). A multivariate analysis showed that: Killip class >1 (OR 7.39; CI:1.47–36.21, P = 0.01), symptom onset-to-wire ≥6 h (OR 7.19; CI 1.07–50.91, P = 0.04), LVEF≤35% using index echocardiography (OR 7.11; CI: 1.27–47.43, P = 0.03), and infarct size ≥40% of LV on index CMR (OR 42.62; CI:7.83–328.29, P < 0.001) independently correlated with a final LVEF≤35%. Clinical models consisted of these parameters could identify 7 out of 15 patients in Group 1 with 100% positive predictive value. Conclusion: Together with other clinical measurements, the assessment of infarct size using late Gadolinium enhancement by CMR during hospitalization is a strong predictor of irreversible reduction in CMR_LVEF ≤35. That could potentially, after validation with future research, aids the selection and treatment of high-risk patients after STEMI, including implantation of prophylactic ICD during index hospitalization.
KW - Cardiac MRI
KW - Prophylactic ICD
KW - Reduced LVEF
KW - STEMI
UR - http://www.scopus.com/inward/record.url?scp=85075400701&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2019.10.034
DO - 10.1016/j.ijcard.2019.10.034
M3 - Journal article
C2 - 31748187
AN - SCOPUS:85075400701
VL - 301
SP - 215
EP - 219
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -
ID: 240144996