PMID- 31761400 OWN - NLM STAT- MEDLINE DCOM- 20201204 LR - 20201214 IS - 1874-1754 (Electronic) IS - 0167-5273 (Linking) VI - 301 DP - 2020 Feb 15 TI - Impact of infarct location and size on clinical outcome after ST-elevation myocardial infarction treated by primary percutaneous coronary intervention. PG - 14-20 LID - S0167-5273(19)33043-8 [pii] LID - 10.1016/j.ijcard.2019.11.123 [doi] AB - BACKGROUND: For patients suffering from acute ST-elevation myocardial infarction (STEMI), it is controversial whether infarct location predicts worse clinical outcome independently of infarct size. We therefore aimed to investigate the prognostic relevance of infarct location in relation to infarct size in STEMI patients treated with contemporary primary percutaneous coronary intervention (PCI). METHODS: Cardiac magnetic resonance was performed in 355 patients with acute STEMI 3 (interquartile range [IQR]: 2-4) days after primary PCI. Infarct location, infarct size, and microvascular obstruction were assessed by late gadolinium enhancement (LGE). Patients were followed for major adverse cardiac events (MACE) at a median follow-up of 35 (IQR: 12-52) months. RESULTS: One hundred and sixty five patients (47%) had anterior STEMI. These patients had a greater infarct size as compared to non-anterior STEMI patients (19 vs. 12% of left ventricular myocardial mass, p < .001), but no significant differences in microvascular obstruction occurrence and extent (p = .26 and p = .09, respectively). MACE occurred in 39 patients (11%). Patients with anterior STEMI had a higher risk of MACE (hazard ratio: 2.01; 95% confidence interval: 1.05-3.83; p = .03). In multivariable analysis, infarct severity by LGE imaging but not its location was independently associated with an increased risk of MACE (hazard ratio: 1.03; 95% confidence interval: 1.01-1.06; p = .01). CONCLUSIONS: The higher rate of medium-term MACE in anterior STEMI treated with contemporary primary PCI is explained by a larger extent of myocardial damage as determined by CMR imaging without any further contribution of infarct location. CI - Copyright (c) 2018 Elsevier B.V. All rights reserved. FAU - Reindl, Martin AU - Reindl M AD - University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. FAU - Holzknecht, Magdalena AU - Holzknecht M AD - University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. FAU - Tiller, Christina AU - Tiller C AD - University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. FAU - Lechner, Ivan AU - Lechner I AD - University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. FAU - Schiestl, Michael AU - Schiestl M AD - University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. FAU - Simma, Felix AU - Simma F AD - University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. FAU - Pamminger, Mathias AU - Pamminger M AD - University Clinic of Radiology, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria. FAU - Henninger, Benjamin AU - Henninger B AD - University Clinic of Radiology, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria. FAU - Mayr, Agnes AU - Mayr A AD - University Clinic of Radiology, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria. FAU - Klug, Gert AU - Klug G AD - University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. FAU - Bauer, Axel AU - Bauer A AD - University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. FAU - Metzler, Bernhard AU - Metzler B AD - University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. FAU - Reinstadler, Sebastian J AU - Reinstadler SJ AD - University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. Electronic address: sebastian.reinstadler@gmail.com. LA - eng PT - Journal Article PT - Observational Study DEP - 20191117 PL - Netherlands TA - Int J Cardiol JT - International journal of cardiology JID - 8200291 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) SB - IM MH - Aged MH - *Anterior Wall Myocardial Infarction/complications/diagnosis MH - Austria/epidemiology MH - Contrast Media/pharmacology MH - Correlation of Data MH - Female MH - Gadolinium/pharmacology MH - Humans MH - Image Enhancement/methods MH - *Magnetic Resonance Imaging, Cine/methods/statistics & numerical data MH - Male MH - Middle Aged MH - Myocardium/*pathology MH - *Percutaneous Coronary Intervention/adverse effects/methods MH - Prognosis MH - Prospective Studies MH - Risk Assessment/*methods MH - *ST Elevation Myocardial Infarction/complications/diagnosis/epidemiology MH - Severity of Illness Index OTO - NOTNLM OT - Cardiovascular magnetic resonance imaging OT - Infarct location OT - ST-elevation myocardial infarction EDAT- 2019/11/26 06:00 MHDA- 2020/12/15 06:00 CRDT- 2019/11/26 06:00 PHST- 2019/06/13 00:00 [received] PHST- 2019/08/01 00:00 [revised] PHST- 2019/11/15 00:00 [accepted] PHST- 2019/11/26 06:00 [pubmed] PHST- 2020/12/15 06:00 [medline] PHST- 2019/11/26 06:00 [entrez] AID - S0167-5273(19)33043-8 [pii] AID - 10.1016/j.ijcard.2019.11.123 [doi] PST - ppublish SO - Int J Cardiol. 2020 Feb 15;301:14-20. doi: 10.1016/j.ijcard.2019.11.123. Epub 2019 Nov 17.