BackgroundCardiac magnetic resonance imaging provides detailed anatomical information on
infarction. However, few studies have investigated the association of these data
with mortality after acute myocardial infarction.ObjectiveTo study the association between data regarding infarct size and anatomy, as
obtained from cardiac magnetic resonance imaging after acute myocardial
infarction, and long-term mortality.MethodsA total of 1959 reports of “infarct size” were identified in 7119 cardiac magnetic
resonance imaging studies, of which 420 had clinical and laboratory confirmation
of previous myocardial infarction. The variables studied were the classic risk
factors – left ventricular ejection fraction, categorized ventricular function,
and location of acute myocardial infarction. Infarct size and acute myocardial
infarction extent and transmurality were analyzed alone and together, using the
variable named “MET-AMI”. The statistical analysis was carried out using the
elastic net regularization, with the Cox model and survival trees.ResultsThe mean age was 62.3 ± 12 years, and 77.3% were males. During the mean follow-up
of 6.4 ± 2.9 years, there were 76 deaths (18.1%). Serum creatinine, diabetes
mellitus and previous myocardial infarction were independently associated with
mortality. Age was the main explanatory factor. The cardiac magnetic resonance
imaging variables independently associated with mortality were transmurality of
acute myocardial infarction (p = 0.047), ventricular dysfunction (p = 0.0005) and
infarcted size (p = 0.0005); the latter was the main explanatory variable for
ischemic heart disease death. The MET-AMI variable was the most strongly
associated with risk of ischemic heart disease death (HR: 16.04; 95%CI: 2.64-97.5;
p = 0.003).ConclusionThe anatomical data of infarction, obtained from cardiac magnetic resonance
imaging after acute myocardial infarction, were independently associated with
long-term mortality, especially for ischemic heart disease death.