PMID- 28950314 OWN - NLM STAT- MEDLINE DCOM- 20181217 LR - 20181217 IS - 2047-2412 (Electronic) IS - 2047-2404 (Linking) VI - 19 IP - 1 DP - 2018 Jan 1 TI - Prognostic impact of unrecognized myocardial scar in the non-culprit territories by cardiac magnetic resonance imaging in patients with acute myocardial infarction. PG - 108-116 LID - 10.1093/ehjci/jex194 [doi] AB - AIMS: Unrecognized myocardial scar by late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) is strongly associated with cardiac event in patients with stable coronary artery disease. The purpose of this study was to evaluate the prognostic impact of unrecognized non-infarct-related LGE (non-IR-LGE) in patients with acute myocardial infarction (AMI). METHODS AND RESULTS: We studied 269 patients with a first clinical episode of AMI underwent cardiac MRI within 6 weeks after onset (209 men; age, 66 +/- 12 years). LGE, cine MRI and T2-weighted imaging were obtained to evaluate the presence and extent of LGE and to evaluate cardiac function. Major adverse cardiac events (MACE) were defined as cardiovascular death, non-fatal AMI, unstable angina requiring revascularization, fatal arrhythmia, and heart failure. Unrecognized non-IR LGE was observed in 13.0% of patients. During follow-up periods (median, 22 months; range, 3-95 months), 8.9% of patients experienced MACE in this study. In addition, 22.9% of patients with unrecognized non-IR LGE and 6.8% of patients without unrecognized non-IR-LGE experienced MACE (P < 0.01). The presence of unrecognized non-IR LGE predicted MACE with a hazard ratio of 3.45 (95% confidential interval, 1.03-11.47; P < 0.01). In addition, unrecognized non-IR LGE was the strongest independent predictors of MACE with a hazard ratio of 3.30 by the Cox proportional hazards model (P < 0.01). In contrast, angiography-proven multi-vessel disease and transmural extent of infarct-related LGE were not independently associated with MACE. CONCLUSION: Among patients with a first clinical episode of AMI, unrecognized non-IR myocardial scar provides incremental prognostic value for predicting MACE beyond that of common clinical, angiographic and functional variables. CI - Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author 2017. For permissions, please email: journals.permissions@oup.com. FAU - Omori, Taku AU - Omori T AD - Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan. FAU - Kurita, Tairo AU - Kurita T AD - Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan. FAU - Dohi, Kaoru AU - Dohi K AD - Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan. FAU - Takasaki, Akihiro AU - Takasaki A AD - Department of Cardiology, Matsusaka Central Hospital, 102 Kawai, Matsusaka 515-8566, Japan. FAU - Nakata, Tomoyuki AU - Nakata T AD - Department of Cardiology, Nagai Hospital, 29-29 Nishimarunouchi, Tsu 514-8508, Japan. FAU - Nakamori, Shiro AU - Nakamori S AD - Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan. FAU - Fujimoto, Naoki AU - Fujimoto N AD - Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan. FAU - Kitagawa, Kakuya AU - Kitagawa K AD - Department of Radiology, Mie University Graduate School of Medicine, 2-174 Edobashi Tsu 514-8507, Japan. FAU - Hoshino, Kozo AU - Hoshino K AD - Department of Cardiology, Nagai Hospital, 29-29 Nishimarunouchi, Tsu 514-8508, Japan. FAU - Tanigawa, Takashi AU - Tanigawa T AD - Department of Cardiology, Matsusaka Central Hospital, 102 Kawai, Matsusaka 515-8566, Japan. FAU - Sakuma, Hajime AU - Sakuma H AD - Department of Radiology, Mie University Graduate School of Medicine, 2-174 Edobashi Tsu 514-8507, Japan. FAU - Ito, Masaaki AU - Ito M AD - Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan. LA - eng PT - Journal Article PL - England TA - Eur Heart J Cardiovasc Imaging JT - European heart journal. Cardiovascular Imaging JID - 101573788 RN - AU0V1LM3JT (Gadolinium) SB - IM EIN - Eur Heart J Cardiovasc Imaging. 2018 Jan 1;19(1):122. PMID: 29088330 MH - Aged MH - Cicatrix/*diagnostic imaging/pathology MH - Cohort Studies MH - Coronary Angiography/methods MH - Diagnostic Errors MH - Female MH - *Gadolinium MH - Humans MH - Kaplan-Meier Estimate MH - Magnetic Resonance Imaging, Cine/*methods MH - Male MH - Middle Aged MH - Multivariate Analysis MH - Myocardial Infarction/*diagnostic imaging/mortality/pathology/surgery MH - Percutaneous Coronary Intervention/*methods MH - Prognosis MH - Proportional Hazards Models MH - Radiographic Image Enhancement/*methods MH - Retrospective Studies MH - Risk Assessment MH - Severity of Illness Index MH - Symptom Assessment MH - Treatment Outcome OTO - NOTNLM OT - acute myocardial infarction OT - cardiac magnetic resonance imaging OT - late gadolinium enhancement OT - prognosis OT - unrecognized myocardial infarction EDAT- 2017/09/28 06:00 MHDA- 2018/12/18 06:00 CRDT- 2017/09/27 06:00 PHST- 2017/06/12 00:00 [received] PHST- 2017/07/10 00:00 [accepted] PHST- 2017/09/28 06:00 [pubmed] PHST- 2018/12/18 06:00 [medline] PHST- 2017/09/27 06:00 [entrez] AID - 4049561 [pii] AID - 10.1093/ehjci/jex194 [doi] PST - ppublish SO - Eur Heart J Cardiovasc Imaging. 2018 Jan 1;19(1):108-116. doi: 10.1093/ehjci/jex194.