Coronary disease & ACSCohort study
Splenic tissue alterations in ST-elevation myocardial infarction: determinants and prognostic implications
- retrospective study
- validated in a separate cohort
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 · development cohort 1,037 · validation cohort 252
- Participants
- 1,037 vs 252
- Exposure
- development cohort vs validation cohort
- development cohortn = 1,037
- validation cohortn = 252
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
Summarised from the published abstract; every number is checked against it