Abstract 4179: Prognostic Impact of Myocardial Contrast Delayed Enhancement with 64-slice Multidetector Computed Tomography After Acute Myocardial Infarction
Background: This study was designed to evaluate the impact of myocardial contrast delayed enhancement (DE) with multidetector computed tomography (MDCT) for predicting clinical outcome after acute myocardial infarction (AMI) treated with successful primary percutaneous coronary intervention (PCI).
Methods: In 70 consecutive patients with first AMI, 64-slice MDCT without iodine reinjection was performed immediately following primary coronary stenting. We measured the size of myocardial contrast DE on MDCT (Figure⇓) and compared with clinical outcome.
Results: Among the 70 patients (the mean follow-up period 17 ± 8 months), 12 patients had major cardiac events (3 cardiac death and 9 heart failure). In a multivariable logistic regression analysis, myocardial contrast DE (chi-square=7.41; p=0.006), serum peak CK-MB (chi-square=3.94; p=0.042), and plasma BNP (chi-square=2.91; p=0.047) were significantly independent predictors for major cardiac events. The size of myocardial contrast DE ≥ 35.5cc were an accurate cut-off value for predicting major cardiac events with a sensitivity of 94% and specificity of 87% by receiver-operating characteristics analysis. Kaplan-Meier analysis demonstrated the higher risk of cardiac events for patients with the size of myocardial contrast DE ≥ 35.5cc than those with < 35.5cc (P=0.001).
Conclusions: Myocardial contrast DE with 64-slice MDCT may be useful for predicting clinical outcome after AMI treated successfully with primary PCI.