Assessment of myocardial infarction by cardiac magnetic resonance imaging and long-term mortality

• Published in: Arquivos brasileiros de cardiologia Vol. 104; no. 2; pp. 159 - 168
• Main Authors: Petriz, João Luiz Fernandes, Gomes, Bruno Ferraz de Oliveira, Rua, Braulio Santos, Azevedo, Clério Francisco, Hadlich, Marcelo Souza, Mussi, Henrique Thadeu Periard, Taets, Gunnar de Cunto, Nascimento, Emília Matos do, Pereira, Basílio de Bragança, Silva, Nelson Albuquerque de Souza e
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Sociedade Brasileira de Cardiologia 01.02.2015; Sociedade Brasileira de Cardiologia - SBC; Sociedade Brasileira de Cardiologia (SBC)
• Subjects: Aged; Aged, 80 and over; CARDIAC & CARDIOVASCULAR SYSTEMS; Cause of Death; Diagnóstico por Imagem; Endpoint Determination; Epidemiologic Methods; Fator de Risco; Female; Humans; Imagem por Ressonância Magnética; Infarto do Miocárdio/fisiopatologia; Magnetic Resonance Imaging - methods; Male; Middle Aged; Mortalidade; Myocardial Infarction - diagnosis; Myocardial Infarction - mortality; Myocardial Infarction - physiopathology; Original; Severity of Illness Index; Time Factors; Vascular Diseases - mortality; Vascular Diseases - physiopathology; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left - physiology; Magnetic Resonance Imaging; Diagnostic Imaging; Infarto do Miocárdio/fisiopatologia; Mortality; Diagnóstico por Imagem; Imagem por Ressonância Magnética; Mortalidade; Myocardial Infarction/physiology; Risk Factor; Fator de Risco
• ISSN: 0066-782X; 1678-4170; 1678-4170
• DOI: 10.5935/abc.20140177

Cardiac magnetic resonance imaging provides detailed anatomical information on infarction. However, few studies have investigated the association of these data with mortality after acute myocardial infarction. To study the association between data regarding infarct size and anatomy, as obtained from cardiac magnetic resonance imaging after acute myocardial infarction, and long-term mortality. A total of 1959 reports of "infarct size" were identified in 7119 cardiac magnetic resonance imaging studies, of which 420 had clinical and laboratory confirmation of previous myocardial infarction. The variables studied were the classic risk factors - left ventricular ejection fraction, categorized ventricular function, and location of acute myocardial infarction. Infarct size and acute myocardial infarction extent and transmurality were analyzed alone and together, using the variable named "MET-AMI". The statistical analysis was carried out using the elastic net regularization, with the Cox model and survival trees. The mean age was 62.3 ± 12 years, and 77.3% were males. During the mean follow-up of 6.4 ± 2.9 years, there were 76 deaths (18.1%). Serum creatinine, diabetes mellitus and previous myocardial infarction were independently associated with mortality. Age was the main explanatory factor. The cardiac magnetic resonance imaging variables independently associated with mortality were transmurality of acute myocardial infarction (p = 0.047), ventricular dysfunction (p = 0.0005) and infarcted size (p = 0.0005); the latter was the main explanatory variable for ischemic heart disease death. The MET-AMI variable was the most strongly associated with risk of ischemic heart disease death (HR: 16.04; 95%CI: 2.64-97.5; p = 0.003). The anatomical data of infarction, obtained from cardiac magnetic resonance imaging after acute myocardial infarction, were independently associated with long-term mortality, especially for ischemic heart disease death.