Impact of Persistent Microvascular Obstruction by Cardiac Magnetic Resonance on Prognosis for ST-segment Elevation Myocardial Infarction

NCT06759532 | Completed DMC

• 2 other identifiers: Persistent MVO on prognosisZ-2017-26-2202-2
• Study Type: observational
• Target: 344
• Locations: 1 country
• Sites: 1

Brief Summary

The aims of the study were to evaluate the predictive value of persistent microvascular obstruction (MVO) by cardiac magnetic resonance for main adverse cardiac events in ST-segment elevation myocardial infarction patients. MVO in the acute phase of myocardial infarction has been considered to be strong predictor of a poor prognosis. We plan to explore the relationship between persistent MVO and the long-term prognosis of patients with STEMI. We made hypothesis that patients with persistent MVO have a poor prognosis.

Conditions

ST Elevation (STEMI) Myocardial Infarction

Keywords

Microvascular occlusion;; ST-segment elevation myocardial infarction; Prognosis

Outcome Measures

Primary Outcomes (1)

• Main aderverse cardiac events

  Composite endpoint of all-cause death, readmission due to heart failure, recurrent myocardial infarction, and unexpected vascularization.

  5 years after myocardiac infarction

Study Arms (3)

Without MVO group

STEMI patients without MVO both in the acutephase and chronic phase of myocardial inarction

with transient MVO group

STEMI patients with MVO only in the acutephase of myocardial inarction

with persietent MVO group

STEMI patients without MVO both in the acutephase and chronic phase of myocardial inarction

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The patients in this study were diagnosis as STEMI, and were plan to undergo primary percutaneous coronary intervention and were plan to underwent cardiac magnetic resonance at 7 days and 6 months after primary percutaneous coronary intervention . The patients were divided into three groups according to the presence of absence of MVO at the first cardiac magnetic resonance and second cardiac magnetic resonance.

You may qualify if:

• ST-segment elevation myocardial infarction undewent primary percutaneous coronary intervention

You may not qualify if:

• contraindications for cardiac magnetic resonance
• severe heart failure
• previous myocardial infarction.

Sponsors & Collaborators

• Chinese PLA General Hospital: lead

Study Sites (1)

Chinese PLA general hospital

Beijing, Beijing Municipality, 10086, China

Location

Related Publications (8)

• Symons R, Pontone G, Schwitter J, Francone M, Iglesias JF, Barison A, Zalewski J, de Luca L, Degrauwe S, Claus P, Guglielmo M, Nessler J, Carbone I, Ferro G, Durak M, Magistrelli P, Lo Presti A, Aquaro GD, Eeckhout E, Roguelov C, Andreini D, Vogt P, Guaricci AI, Mushtaq S, Lorenzoni V, Muller O, Desmet W, Agati L, Janssens S, Bogaert J, Masci PG. Long-Term Incremental Prognostic Value of Cardiovascular Magnetic Resonance After ST-Segment Elevation Myocardial Infarction: A Study of the Collaborative Registry on CMR in STEMI. JACC Cardiovasc Imaging. 2018 Jun;11(6):813-825. doi: 10.1016/j.jcmg.2017.05.023. Epub 2017 Aug 16.

  PMID: 28823746 BACKGROUND

• Bodi V, Gavara J, Lopez-Lereu MP, Monmeneu JV, de Dios E, Perez-Sole N, Bonanad C, Marcos-Garces V, Canoves J, Minana G, Nunez J, Moratal D, Chorro FJ, Rodriguez-Palomares JF, Freixa A, Borras R, Ortiz-Perez JT, Rios-Navarro C. Impact of Persistent Microvascular Obstruction Late After STEMI on Adverse LV Remodeling: A CMR Study. JACC Cardiovasc Imaging. 2023 Jul;16(7):919-930. doi: 10.1016/j.jcmg.2023.01.021. Epub 2023 Apr 12.

  PMID: 37052556 BACKGROUND

• Lechner I, Reindl M, Stiermaier T, Tiller C, Holzknecht M, Oberhollenzer F, von der Emde S, Mayr A, Feistritzer HJ, Carberry J, Carrick D, Bauer A, Thiele H, Berry C, Eitel I, Metzler B, Reinstadler SJ. Clinical Outcomes Associated With Various Microvascular Injury Patterns Identified by CMR After STEMI. J Am Coll Cardiol. 2024 May 28;83(21):2052-2062. doi: 10.1016/j.jacc.2024.03.408.

  PMID: 38777509 BACKGROUND

• Orn S, Manhenke C, Greve OJ, Larsen AI, Bonarjee VV, Edvardsen T, Dickstein K. Microvascular obstruction is a major determinant of infarct healing and subsequent left ventricular remodelling following primary percutaneous coronary intervention. Eur Heart J. 2009 Aug;30(16):1978-85. doi: 10.1093/eurheartj/ehp219. Epub 2009 Jun 6.

  PMID: 19502624 BACKGROUND

• Bodi V, Sanchis J, Lopez-Lereu MP, Nunez J, Sanz R, Palau P, Gomez C, Moratal D, Chorro FJ, Llacer A. Microvascular perfusion 1 week and 6 months after myocardial infarction by first-pass perfusion cardiovascular magnetic resonance imaging. Heart. 2006 Dec;92(12):1801-7. doi: 10.1136/hrt.2005.077305. Epub 2006 Jun 27.

  PMID: 16803939 BACKGROUND

• Weir RA, Murphy CA, Petrie CJ, Martin TN, Balmain S, Clements S, Steedman T, Wagner GS, Dargie HJ, McMurray JJ. Microvascular obstruction remains a portent of adverse remodeling in optimally treated patients with left ventricular systolic dysfunction after acute myocardial infarction. Circ Cardiovasc Imaging. 2010 Jul;3(4):360-7. doi: 10.1161/CIRCIMAGING.109.897439. Epub 2010 Mar 26.

  PMID: 20348438 BACKGROUND

• van Kranenburg M, Magro M, Thiele H, de Waha S, Eitel I, Cochet A, Cottin Y, Atar D, Buser P, Wu E, Lee D, Bodi V, Klug G, Metzler B, Delewi R, Bernhardt P, Rottbauer W, Boersma E, Zijlstra F, van Geuns RJ. Prognostic value of microvascular obstruction and infarct size, as measured by CMR in STEMI patients. JACC Cardiovasc Imaging. 2014 Sep;7(9):930-9. doi: 10.1016/j.jcmg.2014.05.010.

  PMID: 25212799 BACKGROUND

• Rios-Navarro C, Marcos-Garces V, Bayes-Genis A, Husser O, Nunez J, Bodi V. Microvascular Obstruction in ST-Segment Elevation Myocardial Infarction: Looking Back to Move Forward. Focus on CMR. J Clin Med. 2019 Oct 28;8(11):1805. doi: 10.3390/jcm8111805.

  PMID: 31661823 BACKGROUND

MeSH Terms

Conditions

ST Elevation Myocardial Infarction; Myocardial Infarction

Condition Hierarchy (Ancestors)

Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Infarction; Ischemia; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Necrosis

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD

Study Record Dates

• First Submitted: December 30, 2024
• First Posted: January 6, 2025
• Study Start: April 1, 2017
• Primary Completion: July 20, 2024
• Study Completion: October 20, 2024
• Last Updated: January 6, 2025

Record last verified: 2024-12

Locations

CN (1)