Prognostic value of different cardiac magnetic resonance imaging derived parameters in Egyptian patients with ST-elevation myocardial infarction after successful reperfusion by primary percutaneous intervention

Abstract

Background: Cardiac magnetic resonance (CMR) is an extremely accurate and useful modality that can give much data about myocardial damage after acute myocardial infarction and consequently can give a good idea about long-term prognosis. Unfortunately, this modality is still underused in Egypt. We tried to assess the prognostic significance of different parameters derived from CMR in Egyptian patients presenting with ST-elevation myocardial infarction (STEMI) treated by primary percutaneous intervention (PPCI). Twenty-five patients who presented with acute STEMI and were successfully reperfused by PPCI within 12 h from symptoms onset were included. CMR was performed 2–4 days after PPCI. Six months of long-term follow-up for major adverse cardiovascular events (re-infarction, new-onset heart failure and cardiac death) was done. CMR-derived parameters (edema volume, area at risk, infarction volume, infarction percentage, microvascular obstruction volume, microvascular obstruction percentage, myocardial salvage and myocardial salvage index) were analyzed in relation to incidence of major adverse cardiovascular events (MACE). Results: Seven patients suffered from MACE. Univariate logistic regression analysis showed a significant correlation between edema volume (P = 0.04), area at risk (P = 0.05), infarction percentage (P = 0.05) and the occurrence of MACE. Multivariate logistic regression analysis showed that infarction percentage (P = 0.05) is the best parameter that can predict MACE. Conclusion: Infarction percentage is potentially the most important prognosticator derived from CMR in Egyptian patients with acute STEMI successfully reperfused by PPCI.