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Long-term prognostic value of microvascular obstruction by cardiac magnetic resonance in ST-segment elevation myocardial infarction

Author

Listed:
  • Raquel P Amier
  • Casper W H Beijnink
  • José F Rodriguez Palomares
  • Martijn W Smulders
  • Gonzalo Pizarro Sánchez
  • Rodrigo Fernández-Jiménez
  • Filipa X Valente
  • Albert C van Rossum
  • Niels van Royen
  • Borja Ibañez
  • Robin Nijveldt

Abstract

Aims: Microvascular obstruction (MVO) portends a higher risk of remodelling and adverse events following ST-segment elevation myocardial infarction (STEMI). However, data regarding the implications of MVO in STEMI beyond five years of follow-up are scarce. Methods & Results: This is a pooled analysis of three observational studies including 876 prospectively enrolled reperfused first STEMI patients, who underwent cardiac magnetic resonance imaging with late gadolinium enhancement (LGE), between 2003–2019. Median follow-up duration was 6.3 (IQR 3.6–9.3) years. The primary outcome was all-cause mortality. The secondary outcome was a combined endpoint of all-cause mortality and recurrent ischemic events (i.e., myocardial infarction or stroke). We performed Cox regression analyses with a time-dependent covariate. Conclusions: In STEMI patients, the presence of MVO by cardiac magnetic resonance imaging is associated with a more than two-fold higher risk of all-cause mortality up to six years after the index event. This relation seems to dissipate beyond this time period.

Suggested Citation

  • Raquel P Amier & Casper W H Beijnink & José F Rodriguez Palomares & Martijn W Smulders & Gonzalo Pizarro Sánchez & Rodrigo Fernández-Jiménez & Filipa X Valente & Albert C van Rossum & Niels van Royen , 2026. "Long-term prognostic value of microvascular obstruction by cardiac magnetic resonance in ST-segment elevation myocardial infarction," PLOS ONE, Public Library of Science, vol. 21(3), pages 1-10, March.
    • Handle: RePEc:plo:pone00:0344442
    DOI: 10.1371/journal.pone.0344442
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