Evidence map›Paper›PMID 29020248›Full record

ArticleEuropean heart journal2017

Relationship between microvascular obstruction and adverse events following primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: an individual patient data pooled analysis from seven randomized trials.

Suzanne de Waha, Manesh R Patel, Christopher B Granger, E Magnus Ohman, Akiko Maehara, Ingo Eitel, Ori Ben-Yehuda, Paul Jenkins, Holger Thiele, Gregg W Stone

Open access · bronzeAbstract read
PubMed Publisher
In one paragraph

Article in European heart journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 212 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
212citing papers in PubMed, 8 pooled it
19.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

212 citing papers in PubMed, 8 syntheses or guidelines pooled it, 436 citations in OpenAlex.

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  9. TransEndocardial Injection of Autologous Expanded CD34Stem cell reviews and reports · 2026
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  14. Thermodilution-derived temperature recovery time: a novel predictor of microvascular reperfusion and prognosis after myocardial infarction.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2021
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152 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 8 institutions in 2 countries.

Suzanne de WahaUniversity Heart Centre Luebeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Luebeck, Germany.
Manesh R PatelDuke University Medical Centre, 2400 Pratt Street, Durham, NC 27705, USA.
Christopher B GrangerDuke University Medical Centre, 2400 Pratt Street, Durham, NC 27705, USA.
E Magnus OhmanDuke University Medical Centre, 2400 Pratt Street, Durham, NC 27705, USA.
Akiko MaeharaColumbia University Medical Centre, New York Presbyterian Hospital, 630 W 168th Street, New York, NY 10032, USA.
Ingo EitelUniversity Heart Centre Luebeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Luebeck, Germany.
Ori Ben-YehudaColumbia University Medical Centre, New York Presbyterian Hospital, 630 W 168th Street, New York, NY 10032, USA.
Paul JenkinsColumbia University Medical Centre, New York Presbyterian Hospital, 630 W 168th Street, New York, NY 10032, USA.
Holger ThieleUniversity Heart Centre Luebeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Luebeck, Germany.
Gregg W StoneColumbia University Medical Centre, New York Presbyterian Hospital, 630 W 168th Street, New York, NY 10032, USA.
Duke Medical Center · USCardiovascular Research Foundation · USColumbia University · USGerman Centre for Cardiovascular Research · DENew York Hospital Queens · USNewYork–Presbyterian Hospital · USUniversity Hospital Schleswig-Holstein · DEUniversity of Lübeck · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsMicrovascular obstruction (MVO) is the underlying cause for the no-reflow phenomenon in ST-segment elevation myocardial infarction (STEMI). The association between MVO assessed by cardiac magnetic resonance imaging (CMR) and prognosis has not been convincingly demonstrated. We sought to determine the relationship between MVO assessed early after primary percutaneous coronary intervention (PCI) in STEMI and all-cause mortality, hospitalization for heart failure (HF), and reinfarction. METHODS AND

resultsWe performed a pooled analysis using individual patient data from seven randomized primary PCI trials in which MVO was assessed within 7 days after reperfusion by CMR using late gadolinium enhancement imaging (n = 1688). Clinical follow-up was performed for at least 6 months after the index event. Median time to CMR after STEMI was 3 days [interquartile range (IQR) 2-4], and median duration of clinical follow-up was 365 days (IQR 188-374). Microvascular obstruction was present in 960 (56.9%) of patients, and median MVO (percent left ventricular myocardial mass) was 0.47% (IQR 0.00-2.54). A graded response was present between the extent of MVO (per 1.0% absolute increase) and subsequent mortality [Cox adjusted hazard ratio (HR) 1.14, 95% confidence interval (CI) 1.09-1.19, P < 0.0001] and hospitalization for HF (Cox adjusted HR 1.08, 95% CI 1.05-1.12, P < 0.0001). Microvascular obstruction remained significantly associated with all-cause mortality even after further adjustment for infarct size (Cox adjusted HR 1.09, 95% CI 1.01-1.17, P = 0.03). MVO was not significantly related to subsequent reinfarction (P = 0.29).

conclusionsThe presence and extent of MVO measured by CMR after primary PCI in STEMI are strongly associated with mortality and hospitalization for HF within 1 year.

Indexed as

Percutaneous Coronary InterventionAgedCoronary CirculationCoronary OcclusionFemaleHeart FailureHospitalizationHumansKaplan-Meier EstimateMagnetic Resonance AngiographyMaleMicrocirculationMiddle AgedMyocardial ReperfusionRandomized Controlled Trials as TopicRecurrenceMicrovascular obstructionNo-reflow phenomenonPrimary percutaneous coronary interventionPrognosisST-segment elevation myocardial infarction

Identifiers

PMID29020248
OpenAlexW2741900278

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.