Predictive Value of Cardiovascular Magnetic Resonance Related Parameters in STEMI Patients After Primary PCI for Adverse Left Ventricular Remodeling and Major Adverse Cardiovascular Events

Study Overview
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Brief Summary
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This study aim to investigate the predictive value of CMR parameters: infarct size (IS), intramyocardial hemorrhage, microvascular obstruction, area at risk and CMR derived strain parameters with the Major Adverse Cardiovascular Events (MACEs) and myocardial remodeling afterinfarction.

Detailed Description
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Investigators will enroll 500 patients with STEMI after PCI who were admitted to the Chinese PLA General Hospital and other eight hospitals across China: Wuhan Asia Heart Hospital; the First People's Hospital of Yunlin; Chaoyang Hospital, Capital Medical University; Hainan Hospital of PLA General Hospital; the Second Affiliated Hospital of Nanchang University; the Second Hospital of Hebei Medical University; Guizhou Provincial People's Hospital; Affiliated Hospital of Zunyi Medical College between January 2014 and December 2019. CMR was performed at 7 days and 6 months after primary PCI to assess the final infarction size(IS), microvascular obstruction (MVO), intramyocardial hemorrhage(IMH), area at risk (AAR) and related strain parameters. All patients will be followed up by 5 years after adimission. Cardiovascular events concluded stroke, repeat revascularization, rehospitalization for acute heart failure, nonfatal myocardial infarction, and all cause death. All adverse clinical events as well as study end points were monitored and adjudicated by the independent event committee.

Official Title
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Predictors of Cardiovascular Magnetic Resonancerelated Parameters: Intramyocardial Hemorrhage, Microvascular Obstruction , Area at Risk and Strain Related Parameters, and Their Effects on Adverse Ventricular Remodeling and MACEs in STEMI Patients After Primary PCI

Conditions
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Cardiovascular Diseases

Intervention / Treatment
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* Diagnostic Test: cardiovascular magnetic resonance (CMR)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18-80 years. clinically diagnosed ST-segment elevation myocardial infarction. Intended to undergo emergency PCI. Voluntary enrollment and signed informed consent form. Exclusion Criteria: undergoing revascularization (PCI or coronary artery bypass grafting (CABG)) within 6 months; Pregnant and breastfeeding women; Contraindications of CMR: implanted cardiac defibrillator (ICD), claustrophobia, allergy to gadolinium Liver or kidney failure; Malignant tumor; Unconscious at present; systolic blood pressure (SBP) less than 80 mmHg; Patients with bundle branch or fascicular block, insufficient ECG data. Patients with other significant abnormal signs, laboratory tests and clinical disease are unsuitable for participation in the study accessed by clinicians.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: cardiovascular magnetic resonance (CMR)|Testing CMR on patients of 7 days and 6 months after myocardial infarction|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| MACEs | MACEs concluding All-cause mortality, stroke, repeat revascularization, rehospitalization for acute heart failure, nonfatal myocardial infarction | follow up in five years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Left ventricular remodeling | Increase of LVEDV >20% | 6 month after PCI | 
| Contrast-induced acute kidney injury | 25% or 0.5 mg/dl increase in serum creatinine | 48 to 72 hours after PCI | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Intramyocardial Hemorrhage(IMH), Microvascular Obstruction(MVO), Area at Risk(AAR), CMR Related Strain, ST-segment elevation myocardial