TY - JOUR
T1 - Ten-year prognostic impact of cardiac magnetic resonance endpoints in patients with ST-segment elevation myocardial infarction
AU - Elezi, Ben
AU - Marquard, Jasmine Melissa
AU - Kelbæk, Henning
AU - Nepper-Christensen, Lars
AU - Ahtarovski, Kiril
AU - Kyhl, Kasper
AU - Göransson, Christoffer
AU - Islam, Utsho
AU - Køber, Lars
AU - Høfsten, Dan
AU - Pedersen, Frants
AU - Vejlstrup, Niels Grove
AU - Holmvang, Lene
AU - Engstrøm, Thomas
AU - Lønborg, Jacob Thomsen
N1 - © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].
PY - 2026/1/6
Y1 - 2026/1/6
N2 - AIMS: The study aimed to investigate the importance of infarct size (IS), microvascular obstruction (MVO), and myocardial salvage index (MSI) on the 10-year outcome in patients with ST-segment elevation myocardial infarction (STEMI).METHODS AND RESULTS: Patients with STEMI had cardiac magnetic resonance (CMR) performed during admission and after three months to assess acute and three-month IS, MSI, left ventricular ejection fraction (LVEF), MVO and transmurality. Adjusted Cox regression models were used to investigate the association between CMR endpoints and all-cause mortality or hospitalization for heart failure 10 years after STEMI. A total of 811 patients had either acute or follow-up CMR performed. During median follow-up of 10.9 years, 173 (21%) patients died or were hospitalized for heart failure. Acute IS (adjusted hazard ratio (HR): 1.02; 95%-confidence interval (CI): 1.01-1.04; p=0.005), three-month IS (adjusted HR: 1.04; 95%-CI: 1.02-1.06; p<0.001), acute MSI (adjusted HR: 0.99; 95%-CI: 0.98-1.00; p=0.007), three-month MSI (adjusted HR: 0.99; 95%-CI: 0.98-1.00; p=0.004), acute LVEF (adjusted HR: 0.97; 95%-CI: 0.95-0.99; p=0.001), three-month LVEF (adjusted HR: 0.95; 95%-CI: 0.93-0.97; p<0.001), acute transmurality (adjusted HR: 1.01; 95%-CI: 1.00-1.02; p=0.024), and three-month transmurality (adjusted HR: 1.01; 95%-CI: 1.00-1.02; p=0.003) were all significant predictors of the composite outcome. MVO was not associated with the composite outcome (adjusted HR: 1.04; 95%-CI: 0.98-1.09; p=0.20).CONCLUSION: Smaller IS, smaller transmurality, higher MSI, and higher LVEF measured acutely and three months after STEMI were independently associated with lower all-cause mortality and/or hospitalization for heart failure within 10 years after STEMI, whereas MVO was not.Clinical trial registration: Registered with ClinicalTrials.gov (identifiers: NCT01435408 and NCT01960933).
AB - AIMS: The study aimed to investigate the importance of infarct size (IS), microvascular obstruction (MVO), and myocardial salvage index (MSI) on the 10-year outcome in patients with ST-segment elevation myocardial infarction (STEMI).METHODS AND RESULTS: Patients with STEMI had cardiac magnetic resonance (CMR) performed during admission and after three months to assess acute and three-month IS, MSI, left ventricular ejection fraction (LVEF), MVO and transmurality. Adjusted Cox regression models were used to investigate the association between CMR endpoints and all-cause mortality or hospitalization for heart failure 10 years after STEMI. A total of 811 patients had either acute or follow-up CMR performed. During median follow-up of 10.9 years, 173 (21%) patients died or were hospitalized for heart failure. Acute IS (adjusted hazard ratio (HR): 1.02; 95%-confidence interval (CI): 1.01-1.04; p=0.005), three-month IS (adjusted HR: 1.04; 95%-CI: 1.02-1.06; p<0.001), acute MSI (adjusted HR: 0.99; 95%-CI: 0.98-1.00; p=0.007), three-month MSI (adjusted HR: 0.99; 95%-CI: 0.98-1.00; p=0.004), acute LVEF (adjusted HR: 0.97; 95%-CI: 0.95-0.99; p=0.001), three-month LVEF (adjusted HR: 0.95; 95%-CI: 0.93-0.97; p<0.001), acute transmurality (adjusted HR: 1.01; 95%-CI: 1.00-1.02; p=0.024), and three-month transmurality (adjusted HR: 1.01; 95%-CI: 1.00-1.02; p=0.003) were all significant predictors of the composite outcome. MVO was not associated with the composite outcome (adjusted HR: 1.04; 95%-CI: 0.98-1.09; p=0.20).CONCLUSION: Smaller IS, smaller transmurality, higher MSI, and higher LVEF measured acutely and three months after STEMI were independently associated with lower all-cause mortality and/or hospitalization for heart failure within 10 years after STEMI, whereas MVO was not.Clinical trial registration: Registered with ClinicalTrials.gov (identifiers: NCT01435408 and NCT01960933).
U2 - 10.1093/ehjci/jeag001
DO - 10.1093/ehjci/jeag001
M3 - Journal article
C2 - 41493904
SN - 1525-2167
JO - European Heart Journal Cardiovascular Imaging
JF - European Heart Journal Cardiovascular Imaging
ER -