Study Results
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Basic Information
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COMPLETED
324 participants
OBSERVATIONAL
2007-12-24
2023-12-31
Brief Summary
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Recent technical development enabled angiographic derivation of IMR without pressure wire, hyperemic agents, or thermodilution method. In this regard, the current study will evaluate the feasibility of functional angiography-derived IMR (angio-IMR) in the evaluation of MVO after successful primary PCI for STEMI.
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Detailed Description
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Recent technical development enabled angiographic derivation of IMR without pressure wire, hyperemic agents, or thermodilution method. In this regard, the current study will evaluate the feasibility of functional angiography-derived IMR (angio-IMR) in the evaluation of MVO after successful primary PCI for STEMI.
The study population will be derived from the prospective institutional AMI registry of Samsung Medical Center between December 2007 and July 2014. Main results from this registry were published elsewhere (PLoS One. 2017 Jan 12;12(1):e0170115 and Sci Rep. 2019 Jul 4;9(1):9646). In this registry, 515 consecutive patients who presented with acute myocardial infarction and underwent CMR were prospectively enrolled. AMI was defined as evidence of myocardial injury (defined as elevation of cardiac troponin values, with at least one value above the 99th percentile upper reference limit) with necrosis in a clinical setting, consistent with myocardial ischemia. Among the total patients, STEMI patients (n = 332), whose electrocardiogram showed ST-segment elevation more than 1 mm in two or more contiguous leads or a presumably new-onset left bundle branch block, will be analyzed for the current study. For the study purpose, patients with failed primary PCI (n=1), treated by medical treatment alone without PCI (n=4), and no available coronary angiographic images (n=3) will be excluded. Among the remaining 324 patients, functional coronary angiography core laboratory (Shanghai Institute of Cardiovascular Diseases, Shanghai, China) evaluated the quality of angiographic images and additionally exclude patients with insufficient image quality for angio-IMR calculation (n=37). All patients also underwent baseline and 1-year follow-up echocardiography. The Institutional Review Board of Samsung Medical Center approved this study, and all patients provided written informed consent.
The association of Angio-IMR with CMR-derived quantitative parameters (extent of MVO, infarct size, area at risk) and qualitative parameter (presence of MVO) will be analyzed. The discrimination ability of angio-IMR to predict the presence of MVO in CMR will be compared with conventional angiographic measures of culprit vessel reperfusion (TIMI flow grade, myocardial blush grade).
Conditions
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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Patients with Angio-IMR>40 Unit
Patients with angio-IMR\>40U in the culprit vessel after successful primary PCI.
Cardiac magnetic resonance imaging
Cardiac magnetic resonance imaging was performed 5.0 ± 5.8 days after the primary PCI. MVO, infarct size, and myocardial salvage index were quantitatively assessed in CMR.
Patients with Angio-IMR≤40 Unit
Patients with angio-IMR≤40U in the culprit vessel after successful primary PCI.
Cardiac magnetic resonance imaging
Cardiac magnetic resonance imaging was performed 5.0 ± 5.8 days after the primary PCI. MVO, infarct size, and myocardial salvage index were quantitatively assessed in CMR.
Interventions
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Cardiac magnetic resonance imaging
Cardiac magnetic resonance imaging was performed 5.0 ± 5.8 days after the primary PCI. MVO, infarct size, and myocardial salvage index were quantitatively assessed in CMR.
Eligibility Criteria
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Inclusion Criteria
* Successful primary PCI in the culprit vessel
* Underwent cardiac MR during index hospitalization
* Suitable coronary angiographic images for angio-IMR analysis
Exclusion Criteria
* treated by medical treatment alone without PCI
* no available coronary angiographic images
* insufficient image quality for angio-IMR calculation
ALL
No
Sponsors
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RainMed Medical Group
INDUSTRY
Shanghai Institute of Cardiovascular Diseases
OTHER
Samsung Medical Center
OTHER
Responsible Party
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Joo Myung Lee
Assistant Professor
Principal Investigators
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Joo Myung Lee, MD, MPH, PhD
Role: PRINCIPAL_INVESTIGATOR
Samsung Medical Center
Locations
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University of Iowa Carver College of Medicine, Iowa City, IA, USA
Iowa City, Iowa, United States
Shanghai Institute of Cardiovascular Diseases, Shanghai, China
Shanghai, Shanghai Municipality, China
Countries
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References
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Shin D, Kim J, Choi KH, Dai N, Li Y, Lee SH, Joh HS, Kim HK, Kim SM, Ha SJ, Jang MJ, Park TK, Yang JH, Song YB, Hahn JY, Choi SH, Choe YH, Gwon HC, Lee JM. Functional angiography-derived index of microcirculatory resistance validated with microvascular obstruction in cardiac magnetic resonance after STEMI. Rev Esp Cardiol (Engl Ed). 2022 Oct;75(10):786-796. doi: 10.1016/j.rec.2022.01.004. Epub 2022 Mar 3. English, Spanish.
Other Identifiers
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SMCCMR88848439
Identifier Type: -
Identifier Source: org_study_id
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