Clinical Implication CMR in AMI Registry

Study Overview
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Brief Summary
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To evaluate the clinical implication of cardiac magnetic resonance imaging in patients with acute myocardial infarction To determine factors affecting the 6-month remodeling index assessed by cardiac magnetic resonance imaging

Detailed Description
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To date, advances in medical treatment and reperfusion therapy led to markedly decreased morbidity and mortality rate in patients with acute myocardial infarction (AMI). Nevertheless, there is a deterioration of left ventricular systolic function or development of heart failure in 40-50% of surviving patients with AMI after the percutaneous coronary intervention (PCI), and it is related to infarct size at the index procedure. Conventional methods of measuring the infarct size included electrocardiogram, peak cardiac enzyme, and echocardiography, but these do not indicate the exact irreversible tissue damage and only suggest indirect parameters. However, cardiac magnetic resonance imaging (CMR) provides information on infarct size, microvascular obstruction, transmurality, and salvage index, and discriminative function between viable and non-viable myocardium with high spatial resolution. Also, magnetic resonance imaging is used as a gold standard for the evaluation of the myocardial remodeling index. However, it is not well known in which patients occur adverse remodeling for the myocardium and in which patients occur reverse remodeling. Therefore, the investigators sought to evaluate the clinical implication of CMR and to determine factors affecting the 6-month remodeling index assessed by cardiac magnetic resonance imaging through the current registry.

Official Title
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Clinical Implication of Cardiac Magnetic Resonance Imaging for Patients With Acute Myocardial Infarction: Prospective Observational Study

Conditions
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Acute Myocardial Infarction

Intervention / Treatment
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* Procedure: Percutaneous Coronary Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjects diagnosed as type 1 myocardial infarction the presence of acute myocardial injury detected by abnormal cardiac biomarkers in the setting of evidence of acute myocardial ischemia. Exclusion Criteria: Patients who cannot perform cardiac magnetic resonance imaging Target vessel is not suitable for coronary intervention

Ages Eligible for Study
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Minimum Age: 19 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

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| AMI patients treated with PCI<br>Acute myocardial infarction patients who underwent percutaneous coronary intervention and cardiac magnetic resonance imaging | Procedure: Percutaneous Coronary Intervention<br>* Patients with AMI who underwent PCI and CMR at index hospitalization and 6-month follow-up<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in proportion of adverse/reverse remodeling at 6 months | Remodeling index assessed by baseline and follow-up CMR | at 6-month follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Infarct size | Infarct size assessed by baseline CMR | 72 hours after the index procedure | 
| Myocardial salvage index | Myocardial salvage index assessed by baseline CMR | 72 hours after the index procedure | 
| Microvascular obstruction | Microvascular obstruction assessed by baseline CMR | 72 hours after the index procedure | 
| Hemorrhagic infarct | Hemorrhagic infarct assessed by baseline CMR | 72 hours after the index procedure | 
| Transmurality | Transmurality assessed by baseline CMR | 72 hours after the index procedure | 
| Peak cardiac enzyme | Peak cardiac enzyme at index hospitalization | 72 hours after the index procedure | 
| TIMI flow | TIMI flow grade after culprit vessel PCI | Immediate after the index procedure | 
| Changes of LVEDV on CMR | ∆left ventricular end diastolic volume assessed by baseline and follow-up CMR | at 6-month follow-up | 
| Changes of LVESV on CMR | ∆left ventricular end systolic volume assessed by baseline and follow-up CMR | at 6-month follow-up | 
| 6-month Infarct size | Infarct size assessed by 6-month CMR | at 6-month follow-up | 
| 6-month myocardial salvage index | myocardial salvage index assessed by 6-month CMR | at 6-month follow-up | 
| 6-month microvascular obstruction | 6-month microvascular obstruction assessed by 6-month CMR | at 6-month follow-up | 
| 6-month hemorrhagic infarct | 6-month hemorrhagic infarct assessed by 6-month CMR | at 6-month follow-up | 
| Changes of LVEDV on echocardiography | ∆left ventricular end diastolic volume assessed by baseline and follow-up echocardiography | at 6-month follow-up | 
| Changes of LVESV on echocardiography | ∆left ventricular end systolic volume assessed by baseline and follow-up echocardiography | at 6-month follow-up | 
| Changes of LVEF on echocardiography | ∆left ventricular ejection fraction assessed by baseline and follow-up echocardiography | at 6-month follow-up | 
| Cardiac death or heart failure readmission | Cardiac death or heart failure readmission during follow-up | 1-year after last patient enrollment | 
| All-cause death or heart failure readmission | All-cause death or heart failure readmission during follow-up | 1-year after last patient enrollment | 
| Target lesion failure | a composite of cardiac death, myocardial infarction, clinically driven target lesion revascularization | 1-year after last patient enrollment | 
| target vessel failure | a composite of cardiac death, myocardial infarction, clinically driven target vessel revascularization | 1-year after last patient enrollment | 
| All-cause death | Rate of all-cause death during follow-up | 1-year after last patient enrollment | 
| Cardiac death | Rate of cardiac death during follow-up | 1-year after last patient enrollment | 
| Myocardial infarction | Myocardial infarction during follow-up | 1-year after last patient enrollment | 
| Target vessel myocardial infarction | Rate of Target vessel myocardial infarction during follow-up | 1-year after last patient enrollment | 
| Target lesion revascularization | Rate of target lesion revascularization during follow-up | 1-year after last patient enrollment | 
| Target vessel revascularization | Rate of target vessel revascularization during follow-up | 1-year after last patient enrollment | 
| Heart failure readmission | Rate of heart failure readmission during follow-up | 1-year after last patient enrollment | 
| Any readmission | Rate of any readmission during follow-up | 1-year after last patient enrollment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Percutaneous Coronary Intervention, Acute Myocardial Infarction, Cardiac Magnetic Resonance Imaging