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Gavara, JAuthorMoratal, DAuthor

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October 30, 2024
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Prognostic value of cardiac magnetic resonance early after ST-segment elevation myocardial infarction in older patients

Publicated to: AGE AND AGEING. 51 (11): 1-11 - 2022-01-01 51(11), DOI: 10.1093/ageing/afac248

Authors:

Gabaldón-Pérez A; Marcos-Garcés, Víctor; Gavara-Doñate, Josep; López-Lereu, María P.; Monmeneu, José V.; Pérez, Nerea; Ríos-Navarro, César; De Dios, Elena; Merenciano-González, Héctor; Cànoves, Joaquim; Racugno, Paolo; Bonanad, Clara; Minana, Gema; Núnez, Julio; Moratal, David
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Affiliations

ASCIRES Biomed Grp, Cardiovasc Magnet Resonance Unit - Author
Ctr Invest Biomed Red Enfermedades Cardiovasc CIBE - Author
Hlth Res Inst INCLIVA - Author
Hosp Clin Barcelona, Cardiovasc Inst - Author
Hosp Clin Univ Valencia INCLIVA, Inst Invest Sanitaria - Author
Hosp Clin Univ Valencia, Dept Cardiol - Author
Hosp Univ Vall Dhebron, Dept Cardiol - Author
Inst Invest Biomed August Pi i Sunyer IDIBAPS - Author
UNIV AUTONOMA BARCELONA - Author
Univ Politecn Valencia, Ctr Biomat & Tissue Engn - Author
Univ Valencia, Fac Med & Odontol - Author
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Abstract

Background older patients with ST-segment elevation myocardial infarction (STEMI) represent a very high-risk population. Data on the prognostic value of cardiac magnetic resonance (CMR) in this scenario are scarce. Methods the registry comprised 247 STEMI patients over 70 years of age treated with percutaneous intervention and included in a multicenter registry. Baseline characteristics, echocardiographic parameters and CMR-derived left ventricular ejection fraction (LVEF, %), infarct size (% of left ventricular mass) and microvascular obstruction (MVO, number of segments) were prospectively collected. The additional prognostic power of CMR was assessed using adjusted C-statistic, net reclassification index (NRI) and integrated discrimination improvement index (IDI). Results during a 4.8-year mean follow-up, the number of first major adverse cardiac events (MACE) was 66 (26.7%): 27 all-cause deaths and 39 re-admissions for acute heart failure. Predictors of MACE were GRACE score (HR 1.03 [1.02-1.04], P < 0.001), CMR-LVEF (HR 0.97 [0.95-0.99] per percent increase, P = 0.006) and MVO (HR 1.24 [1.09-1.4] per segment, P = 0.001). Adding CMR data significantly improved MACE prediction compared to the model with baseline and echocardiographic characteristics (C-statistic 0.759 [0.694-0.824] vs. 0.685 [0.613-0.756], NRI = 0.6, IDI = 0.08, P < 0.001). The best cut-offs for independent variables were GRACE score > 155, LVEF < 40% and MVO >= 2 segments. A simple score (0, 1, 2, 3) based on the number of altered factors accurately predicted the MACE per 100 person-years: 0.78, 5.53, 11.51 and 78.79, respectively (P < 0.001). Conclusions CMR data contribute valuable prognostic information in older patients submitted to undergo CMR soon after STEMI. The Older-STEMI-CMR score should be externally validated.
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Keywords

Acute heart failureAdverse eventAgedAged, 80 and overAll cause mortalityArticleBlood pressureBlood vessel occlusionCardiac magnetic resonanceCardiovascular magnetic resonanceCardiovascular riskClinical trialCmrCohort analysisComplicationsDiagnostic imagingFemaleFollow upGadobenate dimeglumineGadolinium pentetate meglumineGadoteric acidGrace risk scoreHeart left ventricle ejection fractionHeart left ventricle functionHeart left ventricle massHeart stroke volumeHospital readmissionHumanHumansHypertensionInfarct sizeLate gadolinium enhancement imagingM mode echocardiographyMagnetic resonance spectroscopyMajor adverse cardiac eventMajor clinical studyMaleMicrovascular obstructionMulticenter studyMyocardial infarctionNuclear magnetic resonance spectroscopyObservational studyOlder patientsOlder peopleOutcomesPercutaneous coronary interventionPredictive valuePredictive value of testsPredictorsPrognosisProspective studyRiskSoonSt elevation myocardial infarctionSt segment elevation myocardial infarctionStroke volumeTransthoracic echocardiographyVentricular function, leftVery elderly

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal AGE AND AGEING due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2022, it was in position 10/54, thus managing to position itself as a Q1 (Primer Cuartil), in the category Geriatrics & Gerontology.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2026-04-03:

  • WoS: 5
  • Scopus: 7
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Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-03:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 13.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 10 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 2.
  • The number of mentions on the social network X (formerly Twitter): 4 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
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Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: United Kingdom.

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