Magnetic Resonance Assessment of Left Ventricular Ejection Fraction at Any Time Post‐Infarction for Prediction of Subsequent Events in a Large Multicenter STEMI Registry

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Abstract
Background: Magnetic resonance imaging (MRI) is the most accurate imaging technique for left ventricular ejection fraction (LVEF) quantification, but as yet the prognostic value of LVEF assessment at any time after ST‐segment elevation myocardial infarction (STEMI) for subsequent major adverse cardiac event (MACE) prediction is uncertain.Purpose: To explore the prognostic impact of MRI‐derived LVEF at any time post‐STEMI to predict subsequent MACE (cardiovascular death or re‐admission for acute heart failure).Study Type: Prospective.Population: One thousand thirteen STEMI patients were included in a multicenter registry.Field Strength/Sequence: 1.5‐T. Balanced steady‐state free precession (cine imaging) and segmented inversion recovery steady‐state free precession (late gadolinium enhancement) sequences.Assessment: Post‐infarction MRI‐derived LVEF (reduced [r]: 3 months of follow‐up.Statistical Tests: Multi‐state Markov model to determine the prognostic value of each LVEF state (r‐, mr‐ or p‐) at any time point assessed to predict subsequent MACE. A P‐value P‐value = 0.6).Data Conclusion: LVEF is an important MRI index for simple and dynamic post‐STEMI risk stratification. Detection of r‐LVEF by MRI at any time during follow‐up identifies a subset of patients at high risk of subsequent events.Level of Evidence: 2Technical Efficacy Stage: 2

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