Tissue Characterization in STEMI Using Cardiac MRI: a Multicenter Registry

N/AActive Not RecruitingNCT07291999

Fundación para la Investigación del Hospital Clínico de Valencia500 enrolled

Overview

This multicenter registry includes patients with a first ST-segment elevation myocardial infarction (STEMI) who underwent cardiac magnetic resonance (CMR) imaging during the acute phase and follow-up. The registry is designed to identify clinical and CMR-derived predictors of adverse ventricular remodeling and major adverse cardiac events (MACE). CMR provides accurate and reproducible assessment of infarct size, left ventricular function, microvascular obstruction, and tissue characteristics, enabling detailed prognostic modeling.

Adverse left ventricular remodeling after STEMI is a key determinant of long-term morbidity and mortality. Although primary PCI and guideline-directed therapies have improved outcomes, 10-15% of patients still develop adverse remodeling and heart failure. CMR enables precise measurement of infarct size, left ventricular volumes, ejection fraction, microvascular obstruction, and tissue parameters (T1, extracellular volume), which may enhance risk stratification compared with other imaging techniques. The registry is based on harmonized clinical and imaging datasets from three experienced centers in Spain, forming a large repository of standardized variables. This structure facilitates the identification of predictors of infarct size, ventricular remodeling, and major adverse cardiac events (MACE), and provides a framework for the development of improved prognostic models and the exploration of potential therapeutic targets.

Study Type

OBSERVATIONAL

Enrollment

500

Conditions

Ischemic Cardiovascular Disease Magnetic Resonance

Eligibility

Medical Language ↔ Plain English

Inclusion Criteria: * Age ≥ 18 years * First STEMI evaluated within the first 24 hours of symptom onset * At least one CMR performed during the acute phase * Signed informed consent (for prospective patients) or previous consent (for retrospective inclusion). Exclusion Criteria: * Severe renal failure (GFR \< 30 ml/min) * STEMI \> 24 hours after symptom onset * Contraindications to CMR (e.g., claustrophobia, hemodynamic instability, non-MR-compatible devices, vascular clips) * Pregnancy or breastfeeding.

Locations (3)

Hospital Vall d'Hebron de Barcelona

Barcelona, Spain

Hospital Clínic de Barcelona

Barcelona, Spain

Hospital Clínico de Valencia

Valencia, Spain

Outcomes

Primary Outcomes

Incidence of MACE (Major Adverse Cardiac Events)

The primary endpoint is the occurrence of MACE during follow-up. MACE is defined as a composite of the following events: Cardiac death (death attributable to cardiovascular causes) Heart failure hospitalization (unplanned admission with a primary diagnosis of heart failure) Heart transplantation or durable mechanical circulatory support Appropriate ICD therapy (appropriate shock or anti-tachycardia pacing for ventricular arrhythmia in patients with implantable defibrillators). The occurrence of the first event in the composite will be used for time-to-event analyses. The first event in the composite will be used for time-to-event analyses. Event classification will be determined according to standardized definitions and based on review of available medical records.

Time frame: From hospital discharge (or index CMR) to at least 6 months, with extended follow-up planned for as long as 5 years, subject to data availability.