EuroCMR 2019: optimal timing for CMR after STEMI


  • Mary Corcoran
  • Univadis Medical News
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New findings presented at EuroCMR 2019 in Italy at the weekend suggest that early cardiovascular magnetic resonance imaging (CMR) may be best for timely effective risk stratification after ST­-segment elevation myocardial infarction (STEMI). 

The study included 511 reperfused STEMI patients who underwent post­-reperfusion (median: 4­ days post­-STEMI) and follow­-up (median: 4.8­ months post­-STEMI) CMR. Left ventricular (LV) volumes, function, infarct­ size and microvascular obstruction extent (MVO) were quantified. Three multivariate models were developed including the Thrombolysis-in-Myocardial-Infarction (TIMI) risk­ score plus early post­-STEMI (early CMR) or follow­-up CMR (deferred­ CMR) or both CMRs parameters along with adverse LV remodelling (paired­ CMRs). The primary end­point was a composite of all­ death and heart failure (HF) hospitalisation.

During a median follow-up of 8.5 years, there were 23 deaths and 38 HF hospitalisations. The authors found that early­ CMR, deferred CMR and paired­ CMRs demonstrated similar predictive value for the primary end­point. They noted however that early CMR enabled them to correctly estimate poor outcome in 56 per cent of patients developing the primary end­point between early­ and deferred CMR. 

They concluded that early CMR should be considered the preferred strategy for timely effective risk stratification in STEMI.