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PROGNOSTIC IMPACT OF UNRECOGNIZED MYOCARDIAL SCAR IN NON-INFARCT RELATED CORONARY TERRITORIES DETECTED BY CARDIAC MAGNETIC RESONANCE IMAGING IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
387 JACC April 5, 2016 Volume 67, Issue 13
ACC.i2 Interventional Cardiology PROGNOSTIC IMPACT OF UNRECOGNIZED MYOCARDIAL SCAR IN NON-INFARCT RELATED CORONARY TERRITORIES DETECTED BY CARDIAC MAGNETIC RESONANCE IMAGING IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION Poster Contributions Poster Area, South Hall A1 Monday, April 04, 2016, 9:45 a.m.-10:30 a.m. Session Title: Hemodynamics and Miscellaneous Abstract Category: 1. ACC.i2 Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology Presentation Number: 1254-140 Authors: Taku Omori, Tairo Kurita, Kaoru Dohi, Akihiro Takasaki, Tomoyuki Nakata, Shiro Nakamori, Kakuya Kitagawa, Kozo Hoshino, Hajime Sakuma, Masaaki Ito, Department of Cardiology, Mie University Graduate School of Medicine, Tsu, Japan
Background: Previous report demonstrated unrecognized myocardial scar by late gadolinium enhancement (LGE) MRI is strongly associated with event-free survival in patients with coronary artery disease. However, in acute myocardial infarction (AMI) patients, the prognostic value of myocardial scar by LGE in non-infarct related coronary territories is unknown. The purpose of this study was to evaluate the prognostic impact of unrecognized non-infarcted related LGE (Non-IR-LGE) in patients with first clinical episode of AMI. Methods: Consecutive 256 AMI patients underwent CMR within 2 months after onset (age 66±12 y.o.) were enrolled in this study. Major adverse cardiac events (MACE) was a composite of cardiovascular death, non-fatal AMI, unstable angina, heart failure and fatal arrhythmia.
Results: Unrecognized Non-IR-LGE was observed in 34 of 256 patients (13.3%). During average follow-up of 27 months, 24 of 256 patients (9.4%) reached MACE. Presence of unrecognized Non-IR-LGE predicted the poor outcome with hazard ratio of 4.5 (See figure, P<0.001). By multivariable analyses, Non-IR-LGE and BNP were independent predictors for MACE (p<0.01). In contrast, angiographic finding of multi-vessel disease and decreased LV ejection fraction did not show independent association with MACE. Conclusions: Unrecognized non-IR-LGE provides incremental prognostic value to MACE beyond common clinical, angiographic, and functional predictors among patients with first clinical episode of AMI.
ACC.i2 Interventional Cardiology PROGNOSTIC IMPACT OF UNRECOGNIZED MYOCARDIAL SCAR IN NON-INFARCT RELATED CORONARY TERRITORIES DETECTED BY CARDIAC MAGNETIC RESONANCE IMAGING IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION Poster Contributions Poster Area, South Hall A1 Monday, April 04, 2016, 9:45 a.m.-10:30 a.m. Session Title: Hemodynamics and Miscellaneous Abstract Category: 1. ACC.i2 Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology Presentation Number: 1254-140 Authors: Taku Omori, Tairo Kurita, Kaoru Dohi, Akihiro Takasaki, Tomoyuki Nakata, Shiro Nakamori, Kakuya Kitagawa, Kozo Hoshino, Hajime Sakuma, Masaaki Ito, Department of Cardiology, Mie University Graduate School of Medicine, Tsu, Japan
Background: Previous report demonstrated unrecognized myocardial scar by late gadolinium enhancement (LGE) MRI is strongly associated with event-free survival in patients with coronary artery disease. However, in acute myocardial infarction (AMI) patients, the prognostic value of myocardial scar by LGE in non-infarct related coronary territories is unknown. The purpose of this study was to evaluate the prognostic impact of unrecognized non-infarcted related LGE (Non-IR-LGE) in patients with first clinical episode of AMI. Methods: Consecutive 256 AMI patients underwent CMR within 2 months after onset (age 66±12 y.o.) were enrolled in this study. Major adverse cardiac events (MACE) was a composite of cardiovascular death, non-fatal AMI, unstable angina, heart failure and fatal arrhythmia.
Results: Unrecognized Non-IR-LGE was observed in 34 of 256 patients (13.3%). During average follow-up of 27 months, 24 of 256 patients (9.4%) reached MACE. Presence of unrecognized Non-IR-LGE predicted the poor outcome with hazard ratio of 4.5 (See figure, P<0.001). By multivariable analyses, Non-IR-LGE and BNP were independent predictors for MACE (p<0.01). In contrast, angiographic finding of multi-vessel disease and decreased LV ejection fraction did not show independent association with MACE. Conclusions: Unrecognized non-IR-LGE provides incremental prognostic value to MACE beyond common clinical, angiographic, and functional predictors among patients with first clinical episode of AMI.