1. To evaluate the clinical implication of cardiac magnetic resonance imaging in patients with acute myocardial infarction 2. To determine factors affecting the 6-month remodeling index assessed by cardiac magnetic resonance imaging
To date, advances in medical treatment and reperfusion therapy led to markedly decreased morbidity and mortality rate in patients with acute myocardial infarction (AMI). Nevertheless, there is a deterioration of left ventricular systolic function or development of heart failure in 40-50% of surviving patients with AMI after the percutaneous coronary intervention (PCI), and it is related to infarct size at the index procedure. Conventional methods of measuring the infarct size included electrocardiogram, peak cardiac enzyme, and echocardiography, but these do not indicate the exact irreversible tissue damage and only suggest indirect parameters. However, cardiac magnetic resonance imaging (CMR) provides information on infarct size, microvascular obstruction, transmurality, and salvage index, and discriminative function between viable and non-viable myocardium with high spatial resolution. Also, magnetic resonance imaging is used as a gold standard for the evaluation of the myocardial remodeling index. However, it is not well known in which patients occur adverse remodeling for the myocardium and in which patients occur reverse remodeling. Therefore, the investigators sought to evaluate the clinical implication of CMR and to determine factors affecting the 6-month remodeling index assessed by cardiac magnetic resonance imaging through the current registry.
Study Type
OBSERVATIONAL
Enrollment
500
Patients with AMI who underwent PCI and CMR at index hospitalization and 6-month follow-up
Samsung Medical Center
Seoul, South Korea
RECRUITINGChange from baseline in proportion of adverse/reverse remodeling at 6 months
Remodeling index assessed by baseline and follow-up CMR
Time frame: at 6-month follow-up
Infarct size
Infarct size assessed by baseline CMR
Time frame: 72 hours after the index procedure
Myocardial salvage index
Myocardial salvage index assessed by baseline CMR
Time frame: 72 hours after the index procedure
Microvascular obstruction
Microvascular obstruction assessed by baseline CMR
Time frame: 72 hours after the index procedure
Hemorrhagic infarct
Hemorrhagic infarct assessed by baseline CMR
Time frame: 72 hours after the index procedure
Transmurality
Transmurality assessed by baseline CMR
Time frame: 72 hours after the index procedure
Peak cardiac enzyme
Peak cardiac enzyme at index hospitalization
Time frame: 72 hours after the index procedure
TIMI flow
TIMI flow grade after culprit vessel PCI
Time frame: Immediate after the index procedure
Changes of LVEDV on CMR
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∆left ventricular end diastolic volume assessed by baseline and follow-up CMR
Time frame: at 6-month follow-up
Changes of LVESV on CMR
∆left ventricular end systolic volume assessed by baseline and follow-up CMR
Time frame: at 6-month follow-up
6-month Infarct size
Infarct size assessed by 6-month CMR
Time frame: at 6-month follow-up
6-month myocardial salvage index
myocardial salvage index assessed by 6-month CMR
Time frame: at 6-month follow-up
6-month microvascular obstruction
6-month microvascular obstruction assessed by 6-month CMR
Time frame: at 6-month follow-up
6-month hemorrhagic infarct
6-month hemorrhagic infarct assessed by 6-month CMR
Time frame: at 6-month follow-up
Changes of LVEDV on echocardiography
∆left ventricular end diastolic volume assessed by baseline and follow-up echocardiography
Time frame: at 6-month follow-up
Changes of LVESV on echocardiography
∆left ventricular end systolic volume assessed by baseline and follow-up echocardiography
Time frame: at 6-month follow-up
Changes of LVEF on echocardiography
∆left ventricular ejection fraction assessed by baseline and follow-up echocardiography
Time frame: at 6-month follow-up
Cardiac death or heart failure readmission
Cardiac death or heart failure readmission during follow-up
Time frame: 1-year after last patient enrollment
All-cause death or heart failure readmission
All-cause death or heart failure readmission during follow-up
Time frame: 1-year after last patient enrollment
Target lesion failure
a composite of cardiac death, myocardial infarction, clinically driven target lesion revascularization
Time frame: 1-year after last patient enrollment
target vessel failure
a composite of cardiac death, myocardial infarction, clinically driven target vessel revascularization
Time frame: 1-year after last patient enrollment
All-cause death
Rate of all-cause death during follow-up
Time frame: 1-year after last patient enrollment
Cardiac death
Rate of cardiac death during follow-up
Time frame: 1-year after last patient enrollment
Myocardial infarction
Myocardial infarction during follow-up
Time frame: 1-year after last patient enrollment
Target vessel myocardial infarction
Rate of Target vessel myocardial infarction during follow-up
Time frame: 1-year after last patient enrollment
Target lesion revascularization
Rate of target lesion revascularization during follow-up
Time frame: 1-year after last patient enrollment
Target vessel revascularization
Rate of target vessel revascularization during follow-up
Time frame: 1-year after last patient enrollment
Heart failure readmission
Rate of heart failure readmission during follow-up
Time frame: 1-year after last patient enrollment
Any readmission
Rate of any readmission during follow-up
Time frame: 1-year after last patient enrollment