Clinical Implication of Cardiac Magnetic Resonance Imaging for Patients With Acute Myocardial Infarction: Prospective Observational Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Acute Myocardial Infarction
- Sponsor
- Samsung Medical Center
- Enrollment
- 500
- Locations
- 1
- Primary Endpoint
- Change from baseline in proportion of adverse/reverse remodeling at 6 months
- Status
- Recruiting
- Last Updated
- 3 years ago
Overview
Brief Summary
- To evaluate the clinical implication of cardiac magnetic resonance imaging in patients with acute myocardial infarction
- 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.
Investigators
Young Bin Song
Professor
Samsung Medical Center
Eligibility Criteria
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
Outcomes
Primary Outcomes
Change from baseline in proportion of adverse/reverse remodeling at 6 months
Time Frame: at 6-month follow-up
Remodeling index assessed by baseline and follow-up CMR
Secondary Outcomes
- 6-month hemorrhagic infarct(at 6-month follow-up)
- Infarct size(72 hours after the index procedure)
- Peak cardiac enzyme(72 hours after the index procedure)
- TIMI flow(Immediate after the index procedure)
- 6-month myocardial salvage index(at 6-month follow-up)
- Hemorrhagic infarct(72 hours after the index procedure)
- 6-month microvascular obstruction(at 6-month follow-up)
- All-cause death(1-year after last patient enrollment)
- Myocardial infarction(1-year after last patient enrollment)
- Changes of LVEDV on CMR(at 6-month follow-up)
- Changes of LVEDV on echocardiography(at 6-month follow-up)
- target vessel failure(1-year after last patient enrollment)
- Target lesion revascularization(1-year after last patient enrollment)
- Myocardial salvage index(72 hours after the index procedure)
- Microvascular obstruction(72 hours after the index procedure)
- Transmurality(72 hours after the index procedure)
- Changes of LVESV on CMR(at 6-month follow-up)
- 6-month Infarct size(at 6-month follow-up)
- Changes of LVEF on echocardiography(at 6-month follow-up)
- All-cause death or heart failure readmission(1-year after last patient enrollment)
- Target lesion failure(1-year after last patient enrollment)
- Target vessel myocardial infarction(1-year after last patient enrollment)
- Changes of LVESV on echocardiography(at 6-month follow-up)
- Cardiac death or heart failure readmission(1-year after last patient enrollment)
- Target vessel revascularization(1-year after last patient enrollment)
- Heart failure readmission(1-year after last patient enrollment)
- Cardiac death(1-year after last patient enrollment)
- Any readmission(1-year after last patient enrollment)