Infarct burden following multivessel PCI vs. infarct-only PCI in patients with acute STEMI: the Glasgow PRAMI CMR sub-study

Mangion, K., Carrick, D., Payne, A., McClure, J. , Mason, M., Petrie, M. , McEntegart, M., Eteiba, H., Oldroyd, K. and Berry, C. (2015) Infarct burden following multivessel PCI vs. infarct-only PCI in patients with acute STEMI: the Glasgow PRAMI CMR sub-study. Journal of Cardiovascular Magnetic Resonance, 17(Sup 1), O9. (doi: 10.1186/1532-429X-17-S1-O9) (PMCID:PMC4328183)

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Background: In the Preventive Angioplasty in Myocardial Infarction trial (PRAMI; ISRCTN73028481), immediate multivessel PCI (MV-PCI) of non-IRA (infarct related artery) lesions in patients with acute ST elevation myocardial infarction (STEMI) and multivessel coronary disease (MVD) improved long term prognosis. We assessed infarct distribution and size in a pre-specified cardiac magnetic resonance (CMR) sub-study.<p></p> Methods: In this single centre prospective sub-study, PRAMI participants were invited to undergo 1.5 Tesla CMR 1 week and 1 year after primary PCI. The CMR scans were analysed using semi-automated software by a clinician blinded to treatment group assignment and clinical outcomes. The presence and extent of infarction were assessed quantitatively with late gadolinium enhancement (LGE) imaging (Gadovist, 0.1 mmol/kg). The infarct was delineated as an area of myocardial enhancement (cm2) using a signal intensity threshold of >5SDs above a remote region, and expressed as a % of total LV mass. The incidence of new LGE in non-infarct related artery territories at baseline and 1 year were assessed. Data were analysed by an independent statistician.<p></p> Results: Of 465 randomised trial participants in 6 UK hospitals, 138 (30%) were enrolled in Glasgow. Of these 80 patients underwent CMR 1 week post primary PCI of whom 41 (51%) were in the multi-vessel PCI group and 39 (49%) were in the IRA-only group. At 1 year, 69 (86%) patients had a follow up CMR scan. Infarct size and distribution are described in Table 1.

Item Type:Articles (Other)
Glasgow Author(s) Enlighten ID:Berry, Professor Colin and Carrick, Dr David and Petrie, Professor Mark and Eteiba, Dr Hany and Oldroyd, Dr Keith and Mangion, Dr Kenneth and Payne, Dr Alexander and McClure, Dr John
Authors: Mangion, K., Carrick, D., Payne, A., McClure, J., Mason, M., Petrie, M., McEntegart, M., Eteiba, H., Oldroyd, K., and Berry, C.
Subjects:R Medicine > RC Internal medicine
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Journal of Cardiovascular Magnetic Resonance
Journal Abbr.:JCMR
Publisher:BioMed Central
ISSN (Online):1097-6647
Copyright Holders:Copyright © 2015 The Authors
First Published:First published in Journal of Cardiovascular Magnetic Resonance 17(Sup 1):O9
Publisher Policy:Reproduced under a Creative Commons License

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