Risk score for early risk prediction by cardiac magnetic resonance after acute myocardial infarction.

BACKGROUND: Cardiac magnetic resonance (CMR) performed early after ST-segment elevation myocardial infarction (STEMI) can improve major adverse cardiac event (MACE) risk prediction. We aimed to create a simple clinical-CMR risk score for early MACE risk stratification in STEMI patients. METHODS: We...

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Autores: Marcos-Garces, Victor, Perez, Nerea, Gavara, Jose, Lopez-Lereu, Maria P, Monmeneu, Jose V, Rios-Navarro, Cesar, de Dios, Elena, Merenciano-Gonzalez, Hector, Gabaldon-Perez, Ana, Canoves, Joaquim, Racugno, Paolo, Bonanad, Clara, Minana, Gema, Nunez, Julio, Moratal, David, Chorro, Francisco J, Valente, Filipa, Lorenzatti, Daniel, Ortiz-Perez, Jose T, Rodriguez-Palomares, Jose F, Bodi, Vicente
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p16330
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/16330
Access Level:acceso abierto
Palabra clave:Cardiac magnetic resonance
Left ventricular ejection fraction
Microvascular obstruction
Myocardial infarction
Prognosis
Risk
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spelling Risk score for early risk prediction by cardiac magnetic resonance after acute myocardial infarction.Marcos-Garces, VictorPerez, NereaGavara, JoseLopez-Lereu, Maria PMonmeneu, Jose VRios-Navarro, Cesarde Dios, ElenaMerenciano-Gonzalez, HectorGabaldon-Perez, AnaCanoves, JoaquimRacugno, PaoloBonanad, ClaraMinana, GemaNunez, JulioMoratal, DavidChorro, Francisco JValente, FilipaLorenzatti, DanielOrtiz-Perez, Jose TRodriguez-Palomares, Jose FBodi, VicenteCardiac magnetic resonanceLeft ventricular ejection fractionMicrovascular obstructionMyocardial infarctionPrognosisRiskBACKGROUND: Cardiac magnetic resonance (CMR) performed early after ST-segment elevation myocardial infarction (STEMI) can improve major adverse cardiac event (MACE) risk prediction. We aimed to create a simple clinical-CMR risk score for early MACE risk stratification in STEMI patients. METHODS: We performed a multicenter prospective registry of reperfused STEMI patients (n = 1118) in whom early (1-week) CMR-derived left ventricular ejection fraction (LVEF), infarct size and microvascular obstruction (MVO) were quantified. MACE was defined as a combined clinical endpoint of cardiovascular (CV) death, non-fatal myocardial infarction (NF-MI) or re-admission for acute decompensated heart failure (HF). RESULTS: During a median follow-up of 5.52 [2.63-7.44] years, 216 first MACE (58 CV deaths, 71 NF-MI and 87 HF) were registered. Mean age was 59.3 ± 12.3 years and most patients (82.8%) were male. Based on the four variables independently associated with MACE, we computed an 8-point risk score: time to reperfusion >4.15 h (1 point), GRACE risk score > 155 (3 points), CMR-LVEF <40% (3 points), and MVO >1.5 segments (1 point). This score permitted MACE risk stratification: MACE per 100 person-years was 1.96 in the low-risk category (0-2 points), 5.44 in the intermediate-risk category (3-5 points), and 19.7 in the high-risk category (6-8 points): p < 0.001 in multivariable Cox survival analysis. CONCLUSIONS: A novel risk score including clinical (time to reperfusion >4.15 h and GRACE risk score > 155) and CMR (LVEF <40% and MVO >1.5 segments) variables allows for simple and straightforward MACE risk stratification early after STEMI. External validation should confirm the applicability of the risk score.ELSEVIER IRELAND LTD2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/16330International Journal of CardiologyISSN: 01675273ISSNe: 18741754reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAInglésinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p163302026-06-07T16:35:31Z
dc.title.none.fl_str_mv Risk score for early risk prediction by cardiac magnetic resonance after acute myocardial infarction.
title Risk score for early risk prediction by cardiac magnetic resonance after acute myocardial infarction.
spellingShingle Risk score for early risk prediction by cardiac magnetic resonance after acute myocardial infarction.
Marcos-Garces, Victor
Cardiac magnetic resonance
Left ventricular ejection fraction
Microvascular obstruction
Myocardial infarction
Prognosis
Risk
title_short Risk score for early risk prediction by cardiac magnetic resonance after acute myocardial infarction.
title_full Risk score for early risk prediction by cardiac magnetic resonance after acute myocardial infarction.
title_fullStr Risk score for early risk prediction by cardiac magnetic resonance after acute myocardial infarction.
title_full_unstemmed Risk score for early risk prediction by cardiac magnetic resonance after acute myocardial infarction.
title_sort Risk score for early risk prediction by cardiac magnetic resonance after acute myocardial infarction.
dc.creator.none.fl_str_mv Marcos-Garces, Victor
Perez, Nerea
Gavara, Jose
Lopez-Lereu, Maria P
Monmeneu, Jose V
Rios-Navarro, Cesar
de Dios, Elena
Merenciano-Gonzalez, Hector
Gabaldon-Perez, Ana
Canoves, Joaquim
Racugno, Paolo
Bonanad, Clara
Minana, Gema
Nunez, Julio
Moratal, David
Chorro, Francisco J
Valente, Filipa
Lorenzatti, Daniel
Ortiz-Perez, Jose T
Rodriguez-Palomares, Jose F
Bodi, Vicente
author Marcos-Garces, Victor
author_facet Marcos-Garces, Victor
Perez, Nerea
Gavara, Jose
Lopez-Lereu, Maria P
Monmeneu, Jose V
Rios-Navarro, Cesar
de Dios, Elena
Merenciano-Gonzalez, Hector
Gabaldon-Perez, Ana
Canoves, Joaquim
Racugno, Paolo
Bonanad, Clara
Minana, Gema
Nunez, Julio
Moratal, David
Chorro, Francisco J
Valente, Filipa
Lorenzatti, Daniel
Ortiz-Perez, Jose T
Rodriguez-Palomares, Jose F
Bodi, Vicente
author_role author
author2 Perez, Nerea
Gavara, Jose
Lopez-Lereu, Maria P
Monmeneu, Jose V
Rios-Navarro, Cesar
de Dios, Elena
Merenciano-Gonzalez, Hector
Gabaldon-Perez, Ana
Canoves, Joaquim
Racugno, Paolo
Bonanad, Clara
Minana, Gema
Nunez, Julio
Moratal, David
Chorro, Francisco J
Valente, Filipa
Lorenzatti, Daniel
Ortiz-Perez, Jose T
Rodriguez-Palomares, Jose F
Bodi, Vicente
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Cardiac magnetic resonance
Left ventricular ejection fraction
Microvascular obstruction
Myocardial infarction
Prognosis
Risk
topic Cardiac magnetic resonance
Left ventricular ejection fraction
Microvascular obstruction
Myocardial infarction
Prognosis
Risk
description BACKGROUND: Cardiac magnetic resonance (CMR) performed early after ST-segment elevation myocardial infarction (STEMI) can improve major adverse cardiac event (MACE) risk prediction. We aimed to create a simple clinical-CMR risk score for early MACE risk stratification in STEMI patients. METHODS: We performed a multicenter prospective registry of reperfused STEMI patients (n = 1118) in whom early (1-week) CMR-derived left ventricular ejection fraction (LVEF), infarct size and microvascular obstruction (MVO) were quantified. MACE was defined as a combined clinical endpoint of cardiovascular (CV) death, non-fatal myocardial infarction (NF-MI) or re-admission for acute decompensated heart failure (HF). RESULTS: During a median follow-up of 5.52 [2.63-7.44] years, 216 first MACE (58 CV deaths, 71 NF-MI and 87 HF) were registered. Mean age was 59.3 ± 12.3 years and most patients (82.8%) were male. Based on the four variables independently associated with MACE, we computed an 8-point risk score: time to reperfusion >4.15 h (1 point), GRACE risk score > 155 (3 points), CMR-LVEF <40% (3 points), and MVO >1.5 segments (1 point). This score permitted MACE risk stratification: MACE per 100 person-years was 1.96 in the low-risk category (0-2 points), 5.44 in the intermediate-risk category (3-5 points), and 19.7 in the high-risk category (6-8 points): p < 0.001 in multivariable Cox survival analysis. CONCLUSIONS: A novel risk score including clinical (time to reperfusion >4.15 h and GRACE risk score > 155) and CMR (LVEF <40% and MVO >1.5 segments) variables allows for simple and straightforward MACE risk stratification early after STEMI. External validation should confirm the applicability of the risk score.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://incliva.portalinvestigacion.com/publicaciones/16330
url https://incliva.portalinvestigacion.com/publicaciones/16330
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER IRELAND LTD
publisher.none.fl_str_mv ELSEVIER IRELAND LTD
dc.source.none.fl_str_mv International Journal of Cardiology
ISSN: 01675273
ISSNe: 18741754
reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname:INCLIVA
instname_str INCLIVA
reponame_str r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
collection r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812455

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