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.