{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T11:34:47Z","timestamp":1782732887125,"version":"3.54.5"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"\u2018Austrian Society of Cardiology\u2019, \u2018Tiroler Wissenschaftsf\u00f6rderung\u2019, and \u2018Austrian Science Fund\u2019","award":["KLI 772"],"award-info":[{"award-number":["KLI 772"]}]},{"name":"Lilly, Germany and the University of Leipzig-Heart Centre"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,27]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate the prognostic validity of clinical risk factors as well as infarct characterization and myocardial deformation by cardiac magnetic resonance (CMR) in ST-elevation myocardial infarction (STEMI) patients with preserved left ventricular ejection fraction (LVEF) following primary percutaneous coronary intervention (PCI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>This multicentre, individual patient-data analysis from two large CMR trials included 1247 STEMI patients. Cardiac magnetic resonance examinations were conducted 3 [interquartile range (IQR) 2\u20134] days after PCI. LVEF, infarct size, microvascular obstruction (MVO), and myocardial strain values were measured. Primary endpoint was defined as composite of major adverse cardiovascular events (MACE) including death, re-infarction, and congestive heart failure. A preserved LVEF (defined as LVEF \u226550%) was observed in 724 patients (=58%). In the overall cohort, 97 patients experienced a MACE event [follow-up time 12 (IQR 12\u201313) months], and 34 MACE events occurred in the group with preserved LVEF (5% vs. 12% incidence rate in patients with LVEF &amp;lt; 50%). TIMI risk score [hazard ratio (HR) 1.28, 95% confidence interval (CI) 1.02\u20131.59; P = 0.03] and female gender (HR 2.24, 95% CI 1.10\u20134.57; P = 0.03) emerged as independent clinical determinants of MACE in the patient group with preserved LVEF. Among CMR parameters, the presence of MVO (HR 2.39, 95% CI 1.05\u20135.46; P = 0.04) and reduced global longitudinal strain (GLS; HR 1.12, 95% CI 1.02\u20131.23; P = 0.02) independently predicted MACE in the LVEF-preserved population. The addition of MVO and GLS to the clinical prognostic markers (TIMI risk score, female gender) increased (P = 0.02) the prognostic validity [AUC 0.76 (95% CI 0.73\u20130.79)] compared to the clinical markers alone [AUC 0.65 (0.62\u20130.69)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In contemporary treated STEMI patients showing preserved LVEF, a CMR-based risk prediction approach assessing MVO and GLS provided strong prognostic value that was incremental to clinical outcome parameters.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ehjopen\/oeab033","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T13:08:49Z","timestamp":1636463329000},"source":"Crossref","is-referenced-by-count":13,"title":["Cardiac magnetic resonance imaging improves prognostic stratification of patients with ST-elevation myocardial infarction and preserved ejection fraction"],"prefix":"10.1093","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8414-9552","authenticated-orcid":false,"given":"Martin","family":"Reindl","sequence":"first","affiliation":[{"name":"Department of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck , Anichstrasse 35, A-6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Stiermaier","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Center L\u00fcbeck, Medical Clinic II (Cardiology\/Angiology\/Intensive Care Medicine), University Hospital Schleswig-Holstein , Ratzeburger Allee 160, 23538 L\u00fcbeck, Germany"},{"name":"German Center for Cardiovascular Research (D.Z.H.K.) , P artner Site Hamburg\/Kiel\/L\u00fcbeck , L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Lechner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck , Anichstrasse 35, A-6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Tiller","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck , Anichstrasse 35, A-6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Holzknecht","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck , Anichstrasse 35, A-6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Mayr","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medical University of Innsbruck , Innsbruck 6020 Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes P","family":"Schwaiger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Academic Teaching Hospital Hall in Tirol , Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Brenner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck , Anichstrasse 35, A-6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert","family":"Klug","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck , Anichstrasse 35, A-6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck , Anichstrasse 35, A-6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Thiele","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Cardiology, Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Josef","family":"Feistritzer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Cardiology, Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute , Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Metzler","sequence":"additional","affiliation":[{"name":"Department 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