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:Carrick, Dr David and Mangion, Dr Kenneth and Eteiba, Professor Hany and Petrie, Professor Mark and Oldroyd, Dr Keith and Berry, Professor Colin 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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