Acute Myocardial Infarction
Conditions
Keywords
Percutaneous Coronary Intervention, Acute Myocardial Infarction, Cardiac Magnetic Resonance Imaging
Brief summary
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
Detailed description
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.
Interventions
PROCEDUREPercutaneous Coronary Intervention
Patients with AMI who underwent PCI and CMR at index hospitalization and 6-month follow-up
Sponsors
Samsung Medical Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
19 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Subjects diagnosed as type 1 myocardial infarction the presence of acute myocardial injury detected by abnormal cardiac biomarkers in the setting of evidence of acute myocardial ischemia.
Exclusion criteria
* Patients who cannot perform cardiac magnetic resonance imaging * Target vessel is not suitable for coronary intervention
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline in proportion of adverse/reverse remodeling at 6 months | at 6-month follow-up | Remodeling index assessed by baseline and follow-up CMR |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Myocardial salvage index | 72 hours after the index procedure | Myocardial salvage index assessed by baseline CMR |
| Microvascular obstruction | 72 hours after the index procedure | Microvascular obstruction assessed by baseline CMR |
| Hemorrhagic infarct | 72 hours after the index procedure | Hemorrhagic infarct assessed by baseline CMR |
| Transmurality | 72 hours after the index procedure | Transmurality assessed by baseline CMR |
| Peak cardiac enzyme | 72 hours after the index procedure | Peak cardiac enzyme at index hospitalization |
| TIMI flow | Immediate after the index procedure | TIMI flow grade after culprit vessel PCI |
| Changes of LVEDV on CMR | at 6-month follow-up | ∆left ventricular end diastolic volume assessed by baseline and follow-up CMR |
| Changes of LVESV on CMR | at 6-month follow-up | ∆left ventricular end systolic volume assessed by baseline and follow-up CMR |
| 6-month Infarct size | at 6-month follow-up | Infarct size assessed by 6-month CMR |
| 6-month myocardial salvage index | at 6-month follow-up | myocardial salvage index assessed by 6-month CMR |
| 6-month microvascular obstruction | at 6-month follow-up | 6-month microvascular obstruction assessed by 6-month CMR |
| 6-month hemorrhagic infarct | at 6-month follow-up | 6-month hemorrhagic infarct assessed by 6-month CMR |
| Changes of LVEDV on echocardiography | at 6-month follow-up | ∆left ventricular end diastolic volume assessed by baseline and follow-up echocardiography |
| Infarct size | 72 hours after the index procedure | Infarct size assessed by baseline CMR |
| Changes of LVEF on echocardiography | at 6-month follow-up | ∆left ventricular ejection fraction assessed by baseline and follow-up echocardiography |
| Cardiac death or heart failure readmission | 1-year after last patient enrollment | Cardiac death or heart failure readmission during follow-up |
| All-cause death or heart failure readmission | 1-year after last patient enrollment | All-cause death or heart failure readmission during follow-up |
| Target lesion failure | 1-year after last patient enrollment | a composite of cardiac death, myocardial infarction, clinically driven target lesion revascularization |
| target vessel failure | 1-year after last patient enrollment | a composite of cardiac death, myocardial infarction, clinically driven target vessel revascularization |
| All-cause death | 1-year after last patient enrollment | Rate of all-cause death during follow-up |
| Cardiac death | 1-year after last patient enrollment | Rate of cardiac death during follow-up |
| Myocardial infarction | 1-year after last patient enrollment | Myocardial infarction during follow-up |
| Target vessel myocardial infarction | 1-year after last patient enrollment | Rate of Target vessel myocardial infarction during follow-up |
| Target lesion revascularization | 1-year after last patient enrollment | Rate of target lesion revascularization during follow-up |
| Target vessel revascularization | 1-year after last patient enrollment | Rate of target vessel revascularization during follow-up |
| Heart failure readmission | 1-year after last patient enrollment | Rate of heart failure readmission during follow-up |
| Any readmission | 1-year after last patient enrollment | Rate of any readmission during follow-up |
| Changes of LVESV on echocardiography | at 6-month follow-up | ∆left ventricular end systolic volume assessed by baseline and follow-up echocardiography |
Countries
South Korea
Contacts
Primary ContactYoung Bin Song, MD, PhD
Backup ContactKi Hong Choi, MD
Outcome results
None listed