ArticleJACC. Cardiovascular imaging2023
Acute Response in the Noninfarcted Myocardium Predicts Long-Term Major Adverse Cardiac Events After STEMI.
Article in JACC. Cardiovascular imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Machine Learning Models in Major Cardiovascular Adverse Events Prediction Based on Coronary Computed Tomography Angiography: Systematic Review.Journal of medical Internet research · 2025Pooled it
- Cardiac MRI as Living Histology: Tissue-Based Risk Stratification After STEMI.Journal of magnetic resonance imaging : JMRI · 2026Article
- Prognostic impact of remote myocardium changes using T1 mapping in patients with ST-segment elevation myocardial infarction.European radiology · 2025Article
- Prediction of adverse left ventricular remodeling by culprit lesion features in patients with LAD-related myocardial infarction.Scientific reports · 2025Article
- Prognostic value of the BAB index and a machine learning model integrating the BAB index for predicting mortality in acute ST-segment elevation.Frontiers in nutrition · 2025Article
- Emerging opportunities to target inflammation: myocardial infarction and type 2 diabetes.Cardiovascular research · 2024Review
- Cardiovascular Magnetic Resonance Before Invasive Coronary Angiography in Suspected Non-ST-Segment Elevation Myocardial Infarction.JACC. Cardiovascular imaging · 2024Article
- Management of Myocardial Infarction: Emerging Paradigms for the Future.Methodist DeBakey cardiovascular journal · 2024Review
- Prognostic Value of Systemic Inflammation Response Index and N-Terminal Pro-B-Type Natriuretic Peptide in Patients with Myocardial Infarction with Nonobstructive Coronary Arteries- A Retrospective Study.Journal of inflammation research · 2024Article
- Effects of canagliflozin on myocardial microvascular density, oxidative stress, and proteomic profileJournal of molecular and cellular cardiology plus · 2023Article
- Role of Cardiovascular Imaging in Risk Assessment: Recent Advances, Gaps in Evidence, and Future Directions.Journal of clinical medicine · 2023Review
- Prognostic Value of Systemic Immune-Inflammation Index and NT-proBNP in Patients with Acute ST-Elevation Myocardial Infarction.Clinical interventions in aging · 2023Article
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21 authors.
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Abstract
backgroundAcute ST-segment elevation myocardial infarction (STEMI) has effects on the myocardium beyond the immediate infarcted territory. However, pathophysiologic changes in the noninfarcted myocardium and their prognostic implications remain unclear.
objectivesThe purpose of this study was to evaluate the long-term prognostic value of acute changes in both infarcted and noninfarcted myocardium post-STEMI.
methodsPatients with acute STEMI undergoing primary percutaneous coronary intervention underwent evaluation with blood biomarkers and cardiac magnetic resonance (CMR) at 2 days and 6 months, with long-term follow-up for major adverse cardiac events (MACE). A comprehensive CMR protocol included cine, T2-weighted, T2∗, T1-mapping, and late gadolinium enhancement (LGE) imaging. Areas without LGE were defined as noninfarcted myocardium. MACE was a composite of cardiac death, sustained ventricular arrhythmia, and new-onset heart failure.
resultsTwenty-two of 219 patients (10%) experienced an MACE at a median of 4 years (IQR: 2.5-6.0 years); 152 patients returned for the 6-month visit. High T1 (>1250 ms) in the noninfarcted myocardium was associated with lower left ventricular ejection fraction (LVEF) (51% ± 8% vs 55% ± 9%; P = 0.002) and higher NT-pro-BNP levels (290 pg/L [IQR: 103-523 pg/L] vs 170 pg/L [IQR: 61-312 pg/L]; P = 0.008) at 6 months and a 2.5-fold (IQR: 1.03-6.20) increased risk of MACE (2.53 [IQR: 1.03-6.22]), compared with patients with normal T1 in the noninfarcted myocardium (P = 0.042). A lower T1 (<1,300 ms) in the infarcted myocardium was associated with increased MACE (3.11 [IQR: 1.19-8.13]; P = 0.020). Both noninfarct and infarct T1 were independent predictors of MACE (both P = 0.001) and significantly improved risk prediction beyond LVEF, infarct size, and microvascular obstruction (C-statistic: 0.67 ± 0.07 vs 0.76 ± 0.06, net-reclassification index: 40% [IQR: 12%-64%]; P = 0.007).
conclusionsThe acute responses post-STEMI in both infarcted and noninfarcted myocardium are independent incremental predictors of long-term MACE. These insights may provide new opportunities for treatment and risk stratification in STEMI.
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