PMID- 21805604
OWN - NLM
STAT- MEDLINE
DCOM- 20121010
LR  - 20120607
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 79
IP  - 7
DP  - 2012 Jun 1
TI  - Incidence, predictors, and prognostic value of intramyocardial hemorrhage lesions 
      in ST elevation myocardial infarction.
PG  - 1101-8
LID - 10.1002/ccd.23278 [doi]
AB  - BACKGROUND: Intra myocardial hemorrhage lesions (IMH) are underdiagnosed 
      complication of ST elevation myocardial infarction (STEMI). We sought to 
      determine the incidence, predictors and the prognostic value of IMH in STEMI 
      using cardiac MR imaging (CMR) techniques. METHODS: We screened for inclusion 
      consecutive patients with STEMI treated by percutaneous coronary intervention 
      (PCI) within the first 12 hr of evolution. IMH lesions were identified on 
      T2-weighted sequences on CMR between days 4 and 8 after PCI. Adverse cardiac 
      events were defined as a composite of death + severe ventricular arrhythmias + 
      acute coronary syndrome + acute heart failure. RESULTS: N = 114 patients were 
      included and n = 11 patients (10%) presented IMH lesions. Patients with IMH 
      lesions had a larger myocardial infarction extent (25.6 +/- 1.8 vs. 13.5 +/- 1.0 % LV 
      mass, P < 0.01), microvascular obstructive lesions extent (4.6 +/- 1.0 vs. 1.3 +/- 
      0.3% LV mass, P < 0.01) and lower LV ejection fraction (40.7 +/- 2.3% vs. 50.7 +/- 
      1.3%, P < 0.01). The value of glycemia at admission was an independent predictor 
      of IMH development (Odd ratio 1.8 [1.1-2.8] per mmol l(-1), P = 0.01). The 
      incidence of adverse cardiac events was higher in the IMH group than in the 
      non-IMH group during the first year following STEMI (P = 0.01, log-rank 
      analysis). Cox regression analysis identified the presence of IMH lesions as an 
      independent predictor of adverse clinical outcome (Hazard Ratio = 2.8 [1.2-6.8], 
      P = 0.02). CONCLUSION: Our study indicates that IMH is a rare but severe finding 
      in STEMI, associated with a larger myocardial infarction and a worse clinical 
      outcome. Per-PCI glycemia might influence IMH development.
CI  - Copyright (c) 2011 Wiley Periodicals, Inc.
FAU - Amabile, Nicolas
AU  - Amabile N
AD  - Department of Cardiology, CHU Nord, University of Marseille School of Medicine, 
      Marseille, France. n.amabile@ccml.fr
FAU - Jacquier, Alexis
AU  - Jacquier A
FAU - Shuhab, Anes
AU  - Shuhab A
FAU - Gaudart, Jean
AU  - Gaudart J
FAU - Bartoli, Jean-Michel
AU  - Bartoli JM
FAU - Paganelli, Franck
AU  - Paganelli F
FAU - Moulin, Guy
AU  - Moulin G
LA  - eng
PT  - Journal Article
DEP - 20111212
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
SB  - IM
CIN - Catheter Cardiovasc Interv. 2012 Jun 1;79(7):1109-10. PMID: 22674762
MH  - Aged
MH  - *Angioplasty, Balloon, Coronary/adverse effects/mortality
MH  - Cardiovascular Diseases/mortality
MH  - Chi-Square Distribution
MH  - Female
MH  - France
MH  - Hemorrhage/*diagnosis/mortality/pathology
MH  - Humans
MH  - Hyperglycemia/mortality
MH  - Incidence
MH  - Kaplan-Meier Estimate
MH  - Logistic Models
MH  - *Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myocardial Infarction/*diagnosis/mortality/pathology/*therapy
MH  - Myocardium/*pathology
MH  - Odds Ratio
MH  - Predictive Value of Tests
MH  - Proportional Hazards Models
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2011/08/02 06:00
MHDA- 2012/10/12 06:00
CRDT- 2011/08/02 06:00
PHST- 2011/04/01 00:00 [received]
PHST- 2011/06/12 00:00 [accepted]
PHST- 2011/08/02 06:00 [entrez]
PHST- 2011/08/02 06:00 [pubmed]
PHST- 2012/10/12 06:00 [medline]
AID - 10.1002/ccd.23278 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2012 Jun 1;79(7):1101-8. doi: 10.1002/ccd.23278. Epub 
      2011 Dec 12.