Patel Manesh R, Albert Timothy S E, Kandzari David E, Honeycutt Emily F, Shaw Linda K, Sketch Michael H, Elliott Michael D, Judd Robert M, Kim Raymond J
Cardiovascular Magnetic Resonance Center and Clinical Research Institute, Duke University Medical Center, 2400 Pratt St, Durham, NC 27705, USA.
Radiology. 2006 Sep;240(3):674-80. doi: 10.1148/radiol.2403050740.
To retrospectively determine the safety of cardiac magnetic resonance (MR) imaging performed early (<14 days) after coronary stent implantation in patients with acute myocardial infarction (AMI).
This HIPPA-compliant study was approved by the institutional review board; the informed consent requirement was waived. Consecutive patients with AMI who underwent cardiac MR imaging (study group) shortly after stent implantation (median, 3 days) were compared with control subjects who did not undergo MR imaging and were matched for clinical factors and angiographic extent of coronary disease. A 1.5-T MR imager was used to evaluate cine function, perfusion, and viability. Rates of death, nonfatal myocardial infarction, or revascularization 30 days and 6 months after stent implantation were compared with chi(2) analysis.
The study group consisted of 66 patients (median age, 56 years; 17 women) with 97 stents, 38 (39%) of which were drug eluting. The control group included 124 patients (median age, 58 years; 23% women) with 197 stents, 21 (10.7%) of which were drug eluting. There was no significant (P = .13) difference in the combined end point of death, nonfatal myocardial infarction, or revascularization between the study (2.0% [95% confidence interval: 0.0%, 4.5%]) and control (6.5% [95% confidence interval: 1.6%, 11.3%]) groups at 30-day follow-up. The event-free survival rate at 6-month follow-up was 91% in the study group and 83.7% in the control group (P = .18). Considering the end points separately, there was no difference in the event rate at 30-day or 6-month follow-up between groups. No adverse cardiovascular events occurred in patients with drug-eluting stents who underwent MR imaging.
Cardiac MR imaging performed shortly after AMI and percutaneous revascularization with bare metal or drug-eluting stents appears safe. The risk of adverse cardiovascular events is low and similar to that in patients who do not undergo MR imaging.
回顾性确定急性心肌梗死（AMI）患者冠状动脉支架植入术后早期（<14天）进行心脏磁共振（MR）成像的安全性。
本符合健康保险流通与责任法案（HIPPA）的研究经机构审查委员会批准；豁免了知情同意要求。将支架植入后不久（中位时间为3天）接受心脏MR成像的连续AMI患者（研究组）与未接受MR成像且在临床因素和冠状动脉疾病血管造影范围方面相匹配的对照组进行比较。使用1.5-T MR成像仪评估电影功能、灌注和存活情况。通过卡方分析比较支架植入后30天和6个月时的死亡、非致命性心肌梗死或血运重建率。
研究组由66例患者（中位年龄56岁；17例女性）组成，共植入97枚支架，其中38枚（39%）为药物洗脱支架。对照组包括124例患者（中位年龄58岁；23%为女性），共植入197枚支架，其中21枚（10.7%）为药物洗脱支架。在30天随访时，研究组（2.0%[95%置信区间：0.0%，4.5%]）和对照组（6.5%[95%置信区间：1.6%，11.3%]）在死亡、非致命性心肌梗死或血运重建的联合终点方面无显著差异（P = 0.13）。在6个月随访时，研究组的无事件生存率为91%，对照组为83.7%（P = 0.18）。分别考虑各个终点，两组在30天或6个月随访时的事件发生率无差异。接受MR成像的药物洗脱支架患者未发生不良心血管事件。
AMI后不久以及使用裸金属或药物洗脱支架进行经皮血运重建后进行心脏MR成像似乎是安全的。不良心血管事件的风险较低，与未接受MR成像的患者相似。
