BACKGROUND: Aborted myocardial infarction (MI) is defined by major (> or =50%) ST-segment resolution and a lack of subsequent cardiac enzyme rise > or =2 the upper normal limit. This ultimate myocardial salvage has been observed in approximately 15% of ST-elevation MI (STEMI) patients after fibrinolysis. So far, the prognostic significance and magnetic resonance imaging (MRI) findings of an aborted MI after primary angioplasty have not been evaluated appropriately. METHODS: We examined 420 consecutive STEMI patients undergoing primary angioplasty within 12 hours after symptom onset. All patients underwent MRI within 1 to 4 days. Clinical end points were major adverse cardiovascular events within 6 months after the index event. RESULTS: Of the 420 STEMI patients, 58 (14%) fulfilled aborted MI criteria. As compared with true MI, patients with aborted MI had a significant lower infarct size, shorter pain-to-balloon time, and better left ventricular ejection fraction (P < .001, respectively). Aborted MI patients had a 6-month major adverse cardiovascular event rate of 1.7% versus 19.6% of true MI patients (P = .001). In aborted MI patients, MRI detected no myocardial scar in 30 (56%), and a minor necrosis/scar formation in 24 patients (44%). CONCLUSION: The proven prognostic relevance of aborted MI makes it a meaningful end point and therapeutic target in future MI studies. MRI can further distinguish between true aborted MI with absence of myocardial scar and aborted MI with scar formations.
BACKGROUND:Aborted myocardial infarction (MI) is defined by major (> or =50%) ST-segment resolution and a lack of subsequent cardiac enzyme rise > or =2 the upper normal limit. This ultimate myocardial salvage has been observed in approximately 15% of ST-elevation MI (STEMI) patients after fibrinolysis. So far, the prognostic significance and magnetic resonance imaging (MRI) findings of an aborted MI after primary angioplasty have not been evaluated appropriately. METHODS: We examined 420 consecutive STEMI patients undergoing primary angioplasty within 12 hours after symptom onset. All patients underwent MRI within 1 to 4 days. Clinical end points were major adverse cardiovascular events within 6 months after the index event. RESULTS: Of the 420 STEMI patients, 58 (14%) fulfilled aborted MI criteria. As compared with true MI, patients with aborted MI had a significant lower infarct size, shorter pain-to-balloon time, and better left ventricular ejection fraction (P < .001, respectively). Aborted MIpatients had a 6-month major adverse cardiovascular event rate of 1.7% versus 19.6% of true MI patients (P = .001). In aborted MIpatients, MRI detected no myocardial scar in 30 (56%), and a minor necrosis/scar formation in 24 patients (44%). CONCLUSION: The proven prognostic relevance of aborted MI makes it a meaningful end point and therapeutic target in future MI studies. MRI can further distinguish between true aborted MI with absence of myocardial scar and aborted MI with scar formations.
Authors: Erica Dall'Armellina; Theodoros D Karamitsos; Stefan Neubauer; Robin P Choudhury Journal: Nat Rev Cardiol Date: 2010-09-21 Impact factor: 32.419
Authors: M A G M Olimulder; K Kraaier; M A Galjee; M F Scholten; J van Es; L J Wagenaar; J van der Palen; C von Birgelen Journal: Heart Vessels Date: 2011-05-20 Impact factor: 2.037
Authors: Arthur E Stillman; Matthijs Oudkerk; David Bluemke; Jens Bremerich; Fabio P Esteves; Ernest V Garcia; Matthias Gutberlet; W Gregory Hundley; Michael Jerosch-Herold; Dirkjan Kuijpers; Raymond K Kwong; Eike Nagel; Stamatios Lerakis; John Oshinski; Jean-François Paul; Richard Underwood; Bernd J Wintersperger; Michael R Rees Journal: Int J Cardiovasc Imaging Date: 2010-10-24 Impact factor: 2.357