{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T08:12:34Z","timestamp":1791879154116,"version":"4.3.4"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,6,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Acute complete occlusion of a coronary artery results in progressive ischemia, moving from the endocardium to the epicardium (ie, wavefront). Dependent on time to reperfusion and collateral flow, myocardial infarction (\n                      <jats:styled-content style=\"fixed-case\">MI<\/jats:styled-content>\n                      ) will manifest, with transmural\n                      <jats:styled-content style=\"fixed-case\">MI<\/jats:styled-content>\n                      portending poor prognosis. Late gadolinium enhancement cardiac magnetic resonance imaging can detect\n                      <jats:styled-content style=\"fixed-case\">MI<\/jats:styled-content>\n                      with\u00a0\u00a0high diagnostic accuracy. Primary percutaneous coronary intervention is the preferred reperfusion strategy in patients with\n                      <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>\n                      \u2010segment\u2013elevation MI with &lt;12\u00a0hours of symptom onset. We sought to visualize time\u2010dependent necrosis in a population with\n                      <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>\n                      \u2010segment\u2013elevation MI by using late gadolinium enhancement cardiac magnetic resonance imaging (STEMI\u2010SCAR project).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>\n                      \u2010segment\u2013elevation MI patients with single\u2010vessel disease, complete occlusion with TIMI (Thrombolysis in Myocardial Infarction) score 0, absence of collateral flow (Rentrop score 0), and symptom onset &lt;12\u00a0hours were consecutively enrolled. Using late gadolinium enhancement cardiac magnetic resonance imaging, the area at risk and infarct size, myocardial salvage index, transmurality index, and transmurality grade (0\u201350%, 51\u201375%, 76\u2013100%) were determined. In total, 164 patients (aged 54\u00b111\u00a0years, 80% male) were included. A receiver operating characteristic curve (area under the curve: 0.81) indicating transmural necrosis revealed the best diagnostic cutoff for a symptom\u2010to\u2010balloon time of 121\u00a0minutes: patients with &gt;121\u00a0minutes demonstrated increased infarct size, transmurality index, and transmurality grade (all\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01) and decreased myocardial salvage index (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) versus patients with symptom\u2010to\u2010balloon times \u2264121\u00a0minutes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      In MI with no residual antegrade and no collateral flow, immediate reperfusion is vital. A symptom\u2010to\u2010balloon time of &gt;121\u00a0minutes causes a high grade of transmural necrosis. In this pure\n                      <jats:styled-content style=\"fixed-case\">ST<\/jats:styled-content>\n                      \u2010segment\u2013elevation MI population, time to reperfusion to salvage myocardium was less than suggested by current guidelines.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.119.012429","type":"journal-article","created":{"date-parts":[[2019,6,11]],"date-time":"2019-06-11T05:00:33Z","timestamp":1560229233000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":50,"title":["Time\u2010Dependent Myocardial Necrosis in Patients With ST\u2010Segment\u2013Elevation Myocardial Infarction Without Angiographic Collateral Flow Visualized by Cardiac Magnetic Resonance Imaging: Results From the Multicenter STEMI\u2010SCAR Project"],"prefix":"10.1161","volume":"8","author":[{"given":"Simon","family":"Greulich","sequence":"first","affiliation":[{"name":"Department of Cardiology and Cardiovascular Diseases University of T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Mayr","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Gloekler","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inselspital Bern University Hospital University of Bern Switzerland"},{"name":"Department of Cardiology Schwarzwald\u2010Baar Klinikum Villingen\u2010Schwenningen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Seitz","sequence":"additional","affiliation":[{"name":"Department of Cardiology Robert Bosch Medical Center Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Birkmeier","sequence":"additional","affiliation":[{"name":"Department of Cardiology Robert Bosch Medical Center Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Sch\u00e4ufele","sequence":"additional","affiliation":[{"name":"Department of Cardiology Robert Bosch Medical Center Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffi","family":"Bekeredjian","sequence":"additional","affiliation":[{"name":"Department of Cardiology Robert Bosch Medical Center Stuttgart Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine S.","family":"Zuern","sequence":"additional","affiliation":[{"name":"Department of Cardiology Universit\u00e4tsspital Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Seizer","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Diseases University of T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Geisler","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiovascular Diseases University of T\u00fcbingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin A. 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