Associations and prognostic implications of myocardial tissue injury stages in ST-elevation myocardial infarction using the Canadian Cardiovascular Society classification
Authors' conclusion
This study describes clinical characteristics across CCS stages and provides insights into their prognostic implications in a large cohort of STEMI patients reperfused by percutaneous coronary intervention. These data should inform the use of CCS stages in future trial designs.
Study context
- Population
- ST-elevation myocardial infarction (STEMI) patients reperfused by percutaneous coronary intervention, classified by Canadian Cardiovascular Society (CCS) tissue injury stage on cardiac magnetic resonance (CMR)STEMI patients included in three prospective studies
- Participants
- 1,109 patients
- Exposure
- Clinical characteristics and outcomes across CCS stages
- Outcome
- MACE
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Mortality
| Outcome | Hazard ratio (95% CI) | P value | |
|---|---|---|---|
| MACE, multivariable Cox regressionPer CCS stage; independently associated | 2.18 (1.70–2.78) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
- Mortality: P < 0.001
Predictive value of CCS stage for major adverse cardiovascular event (MACE) and mortality · 12 months
- AUC for MACE
- 0.74 (95% CI: 0.68-0.80), P < 0.001
- AUC for mortality
- 0.71 (95% CI: 0.61-0.80), P < 0.001
Clinical presentation, biomarker profiles, cardiac function
- Distinct patterns across the different CCS stages
- CMR performed 3 (interquartile range 2-5) days after myocardial infarction (MI)
Original publication
Associations and prognostic implications of myocardial tissue injury stages in ST-elevation myocardial infarction using the Canadian Cardiovascular Society classification. Eur Heart J Cardiovasc Imaging. Published 22 August 2025. doi:10.
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