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Intramyocardial Hemorrhage Leads to Higher MACE Rate by Increasing Myocardial Infarction Volume in Patients with

Zhijian Wu1,2,3, Xiaotian Jin1, Ilyas Tudahun1

  • 1Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, 410011, People's Republic of China.

International Journal of General Medicine
|January 29, 2024
PubMed

Insights

Intramyocardial hemorrhage (IMH) in ST-elevation myocardial infarction (STEMI) patients increases myocardial infarction (MI) volume and lowers ejection fraction. This leads to a higher major adverse cardiovascular event (MACE) rate after reperfusion therapy.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Interventional Cardiology

Background:

  • The direct impact of intramyocardial hemorrhage (IMH) on persistent myocardial necrosis following reperfusion therapy in ST-elevation myocardial infarction (STEMI) patients remains unclear.
  • Investigating the correlation between IMH and adverse cardiovascular outcomes is crucial for STEMI patient management.

Purpose of the Study:

  • To compare cardiovascular parameters in STEMI patients with and without IMH.
  • To explore the potential relationship between IMH and poor cardiovascular outcomes after primary percutaneous coronary intervention (PCI).

Main Methods:

  • A prospective study enrolled 65 STEMI patients undergoing primary PCI.
  • Patients were categorized into IMH-absent (n=38) and IMH-present (n=27) groups.
  • Cardiovascular parameters, including myocardial infarction (MI) volume (LGE-CMR), hs-TNT levels, LVEF (CMR), and Major Adverse Cardiovascular Events (MACE), were assessed post-reperfusion and at 12-month follow-up.

Main Results:

  • STEMI patients with IMH exhibited significantly larger MI volumes (34.2 ± 12.7 cm³ vs 21.1 ± 13.1 cm³, P<0.001) compared to those without IMH.
  • The IMH-present group showed higher hs-TNT levels (P=0.021) and lower LVEF (30.7 ± 9.8% vs 42.3 ± 11.0%, P<0.001).
  • A significantly higher MACE rate at 12 months was observed in the IMH-present group (9/27 vs 2/38, P=0.012).

Conclusions:

  • Intramyocardial hemorrhage (IMH) is associated with increased myocardial infarction (MI) volume in STEMI patients.
  • IMH contributes to reduced left ventricular ejection fraction (LVEF) and a higher incidence of major adverse cardiovascular events (MACE) post-discharge.
  • IMH is a significant predictor of poor outcomes in STEMI patients treated with primary PCI.
Abstract

Keywords:
cardiac magnetic resonanceinfarction volumeintramyocardial hemorrhagemyocardial infarctionoutcome

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