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.

摘要: Aims Microvascular obstruction (MVO) is the underlying cause for 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 relationship early after primary percutaneous coronary intervention (PCI) STEMI all-cause mortality, hospitalization heart failure (HF), reinfarction. Methods results performed a pooled analysis using individual patient data from seven randomized PCI trials which was within 7 days reperfusion CMR late gadolinium enhancement (n = 1688). Clinical follow-up at least 6 months index event. Median time 3 [interquartile range (IQR) 2-4], median duration of clinical 365 (IQR 188-374). present 960 (56.9%) patients, (percent left ventricular mass) 0.47% 0.00-2.54). A graded response extent (per 1.0% absolute increase) subsequent mortality [Cox adjusted hazard ratio (HR) 1.14, 95% confidence interval (CI) 1.09-1.19, P < 0.0001] HF (Cox HR 1.08, CI 1.05-1.12, P < 0.0001). remained significantly associated with even further adjustment infarct size 1.09, 1.01-1.17, P = 0.03). related reinfarction (P = 0.29). Conclusions presence measured are strongly 1 year.