Splenic tissue alterations in ST-elevation myocardial infarction: determinants and prognostic implications
Authors' conclusion
Elevated splenic T1 z-score and ECV assessed by CMR after STEMI independently predicted MACE, mainly because of higher risk of heart failure and non-target vessel re-infarction, providing incremental prognostic value over traditional clinical and imaging risk markers.
Study context
- Population
- STEMI patients undergoing cardiac magnetic resonance (CMR) within 10 days after primary percutaneous coronary intervention (April 2017-October 2024)development and validation cohorts
- Participants
- 1,037 vs 252
- Exposure
- Development cohort vs validation cohort
- Development cohortn = 1,037
- Validation cohortn = 252
- Outcome
- MACE events
- Follow-up
- Median 38 and 30 months
Methodological detailsvalidated in a separate cohort
- Validated in a separate cohort
Main finding
As reported in the abstract
Development cohort
207
events
Validation cohort
40
events
Observational data: associations, not effects.
Further findings
Major adverse cardiovascular events (MACE) predicted by splenic T1 z-score and splenic extracellular volume (ECV) (multivariable Cox regression)
- Elevated splenic T1 z-score, adjusted HR
- 1.58
- Splenic ECV, adjusted HR
- 1.22
- Driven primarily by heart failure and non-target vessel re-infarction
- Independently predicted MACE
Discrimination of model combining clinical and conventional myocardial imaging risk factors with splenic T1 z-score
- Development C index
- 0.87
- Validation C index
- 0.85
- Best discrimination among all tested models
Original publication
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