Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Sub-acute cardiac magnetic resonance to predict irreversible reduction in left ventricular ejection fraction after ST-segment elevation myocardial infarction: A DANAMI-3 sub-study

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Association between the E-wave propagation index and left ventricular thrombus formation after ST-elevation myocardial infarction

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Temporal changes in the incidence of infective endocarditis in Denmark 1997-2017: A nationwide study

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Reply to: TFC ECG in arrhythmogenic cardiomyopathy: Inadequate mixture of criteria?

    Research output: Contribution to journalComment/debateResearchpeer-review

  4. Looking beyond antiplatelet effect of P2Y12 inhibitors: is there anything to see?

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Diagnostic findings and follow-up outcomes in relatives to young non-autopsied sudden death victims

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Temporal changes in the incidence of infective endocarditis in Denmark 1997-2017: A nationwide study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Prevalence of Bicuspid Aortic Valve and Associated Aortopathy in Newborns in Copenhagen, Denmark

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Atrial fibrillation is a marker of increased mortality risk in non-ischemic heart failure - results from the DANISH Trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Biomarkers and Their Relation to Cardiac Function Late After Peripartum Cardiomyopathy

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

AIMS: To predict irreversible reduction in left ventricular ejection fraction (LVEF) during admission for ST-segment elevation myocardial infarction (STEMI) using cardiac magnetic resonance (CMR) in addition to classical clinical parameters. Irreversible reduction in LVEF is an important prognostic factor after STEMI which necessitates medical therapy and implantation of prophylactic implantable cardioverter defibrillator (ICD).

METHODS AND RESULTS: A post-hoc analysis of DANAMI-3 trial program (Third DANish Study of Optimal Acute Treatment of Patients With ST-elevation Myocardial Infarction) which recruited 649 patients who had CMR performed during index hospitalization and after 3 months. Patients were divided into two groups according to CMR-LVEF at 3 months: Group 1 with LVEF≤35% and Group 2 with LVEF>35%. Group 1 included 15 patients (2.3%) while Group 2 included 634 patients (97.7%). A multivariate analysis showed that: Killip class >1 (OR 7.39; CI:1.47-36.21, P = 0.01), symptom onset-to-wire ≥6 h (OR 7.19; CI 1.07-50.91, P = 0.04), LVEF≤35% using index echocardiography (OR 7.11; CI: 1.27-47.43, P = 0.03), and infarct size ≥40% of LV on index CMR (OR 42.62; CI:7.83-328.29, P < 0.001) independently correlated with a final LVEF≤35%. Clinical models consisted of these parameters could identify 7 out of 15 patients in Group 1 with 100% positive predictive value.

CONCLUSION: Together with other clinical measurements, the assessment of infarct size using late Gadolinium enhancement by CMR during hospitalization is a strong predictor of irreversible reduction in CMR_LVEF ≤35. That could potentially, after validation with future research, aids the selection and treatment of high-risk patients after STEMI, including implantation of prophylactic ICD during index hospitalization.

Original languageEnglish
JournalInternational Journal of Cardiology
Volume301
Pages (from-to)215-219
ISSN0167-5273
DOIs
Publication statusPublished - 15 Feb 2020

    Research areas

  • Cardiac MRI, Prophylactic ICD, Reduced LVEF, STEMI

ID: 58442443