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

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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. / Alzuhairi, Karam Sadoon; Lønborg, Jacob; Ahtarovski, Kiril Aleksov; Nepper-Christensen, Lars; Kyhl, Kasper; Lassen, Jens F.; Sørensen, Rikke; Joshi, Francis; Ghotbi, Adam Ali; Schoos, Mikkel; Goransson, Christoffer; Bertelsen, Litten; Helqvist, Steffen; Holmvang, Lene; Jørgensen, Erik; Pedersen, Frants; Tilsted, Hans Henrik; Høfsten, Dan; Køber, Lars; Kelbæk, Henning; Vejlstrup, Niels; Engstrøm, Thomas.

In: International Journal of Cardiology, Vol. 301, 15.02.2020, p. 215-219.

Research output: Contribution to journalArticle

Harvard

Alzuhairi, KS, Lønborg, J, Ahtarovski, KA, Nepper-Christensen, L, Kyhl, K, Lassen, JF, Sørensen, R, Joshi, F, Ghotbi, AA, Schoos, M, Goransson, C, Bertelsen, L, Helqvist, S, Holmvang, L, Jørgensen, E, Pedersen, F, Tilsted, HH, Høfsten, D, Køber, L, Kelbæk, H, Vejlstrup, N & Engstrøm, T 2020, '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', International Journal of Cardiology, vol. 301, pp. 215-219. https://doi.org/10.1016/j.ijcard.2019.10.034

APA

CBE

Alzuhairi KS, Lønborg J, Ahtarovski KA, Nepper-Christensen L, Kyhl K, Lassen JF, Sørensen R, Joshi F, Ghotbi AA, Schoos M, Goransson C, Bertelsen L, Helqvist S, Holmvang L, Jørgensen E, Pedersen F, Tilsted HH, Høfsten D, Køber L, Kelbæk H, Vejlstrup N, Engstrøm T. 2020. 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. International Journal of Cardiology. 301:215-219. https://doi.org/10.1016/j.ijcard.2019.10.034

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Author

Alzuhairi, Karam Sadoon ; Lønborg, Jacob ; Ahtarovski, Kiril Aleksov ; Nepper-Christensen, Lars ; Kyhl, Kasper ; Lassen, Jens F. ; Sørensen, Rikke ; Joshi, Francis ; Ghotbi, Adam Ali ; Schoos, Mikkel ; Goransson, Christoffer ; Bertelsen, Litten ; Helqvist, Steffen ; Holmvang, Lene ; Jørgensen, Erik ; Pedersen, Frants ; Tilsted, Hans Henrik ; Høfsten, Dan ; Køber, Lars ; Kelbæk, Henning ; Vejlstrup, Niels ; Engstrøm, Thomas. / 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. In: International Journal of Cardiology. 2020 ; Vol. 301. pp. 215-219.

RIS

TY - JOUR

T1 - Sub-acute cardiac magnetic resonance to predict irreversible reduction in left ventricular ejection fraction after ST-segment elevation myocardial infarction

T2 - A DANAMI-3 sub-study

AU - Alzuhairi, Karam Sadoon

AU - Lønborg, Jacob

AU - Ahtarovski, Kiril Aleksov

AU - Nepper-Christensen, Lars

AU - Kyhl, Kasper

AU - Lassen, Jens F.

AU - Sørensen, Rikke

AU - Joshi, Francis

AU - Ghotbi, Adam Ali

AU - Schoos, Mikkel

AU - Goransson, Christoffer

AU - Bertelsen, Litten

AU - Helqvist, Steffen

AU - Holmvang, Lene

AU - Jørgensen, Erik

AU - Pedersen, Frants

AU - Tilsted, Hans Henrik

AU - Høfsten, Dan

AU - Køber, Lars

AU - Kelbæk, Henning

AU - Vejlstrup, Niels

AU - Engstrøm, Thomas

PY - 2020/2/15

Y1 - 2020/2/15

N2 - 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.

AB - 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.

KW - Cardiac MRI

KW - Prophylactic ICD

KW - Reduced LVEF

KW - STEMI

U2 - 10.1016/j.ijcard.2019.10.034

DO - 10.1016/j.ijcard.2019.10.034

M3 - Article

VL - 301

SP - 215

EP - 219

JO - European Journal of Cardiology

JF - European Journal of Cardiology

SN - 0167-5273

ER -