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Enhancement patterns detected by multidetector computed tomography are associated with the long-term prognosis of patients with acute myocardial infarction

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Abstract

The present study investigated the clinical value of myocardial contrast-delayed enhancement (DE) with multidetector computed tomography (MDCT) without iodine re-injection immediately after primary percutaneous coronary intervention (PCI) for predicting future cardiovascular events after acute myocardial infarction (AMI). We performed a prospective study in which 263 consecutive patients with first AMI successfully treated with primary PCI were enrolled. Sixty-four-slice MDCT without the re-injection of contrast medium was performed immediately after PCI. Myocardial DE was considered to be transmural when involving myocardial thickness ≥ 75% (Group A; n = 104), subendocardial (< 75%, Group B; n = 108), or normal (Group C; n = 51). A semiquantitative scale score was defined for 17 left ventricular segments to investigate the extent of the DE area assessed. We examined the relationship between the presence or absence of transmural DE and long-term cardiovascular event rates. The median follow-up period was 3.5 years. Kaplan–Meier survival curves showed that patient prognosis was poorer in the group with Group A than that in the group with Group B, which was equivalent to that with Group C. A multivariate analysis identified the presence of transmural DE as the strongest predictor for future cardiovascular events (hazard ratio: 3.7; P = 0.023). Transmural myocardial DE immediately following primary PCI without an iodine re-injection for AMI is a major risk factor for future cardiovascular events.

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Data availability

The deidentified participant data will be shared on a request basis. Please directly contact the corresponding author to request data sharing. Data will be available during the 9–24 months after the publication.

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Acknowledgements

We gratefully thank Medical English Service (Kyoto, Japan) for their critical reading of the English in the manuscript.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Nishinomiya Watanabe Cardiovascular Center, 3-25 Ikeda-cho, Nishinomiya, 662-0911, Japan

    Koichi Tamita, Atsushi Yamamuro, Mika Maeda, Takeshi Tokuda & Kazunori Yoshida

  2. Department of Radiology, Nishinomiya Watanabe Cardiovascular Center, Nishinomiya, Japan

    Hiromi Hashimura

  3. Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan

    Yasuhiro Izumiya & Minoru Yoshiyama

Authors
  1. Koichi Tamita
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  2. Atsushi Yamamuro
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Contributions

KT.: performed statistical analyses. MY: handled supervision. KT, YA, HH, MM, TT: acquired data. KT: conceived and designed the research and drafted the manuscript. YI and HH: made critical revisions of the manuscript for key intellectual content.

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Correspondence to Koichi Tamita.

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The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Ethical approval

This study was conducted in compliance with the Declaration of Helsinki and approved by the Committee for the Protection of Human Subjects in Research (reference number: 20091201) at the Nishinomiya Watanabe Cardiovascular Center.

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Tamita, K., Yamamuro, A., Hashimura, H. et al. Enhancement patterns detected by multidetector computed tomography are associated with the long-term prognosis of patients with acute myocardial infarction. Heart Vessels 36, 1784–1793 (2021). https://doi.org/10.1007/s00380-021-01868-1

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