Table 4.
Multivariable associates of adverse LV remodelling revealed by cardiac magnetic resonance in ST-elevation myocardial infarction survivorsa after 6 months follow-up
| Multivariable associations | Odds ratio (95% CI) | P-value |
|---|---|---|
| A. Patient and angiographic characteristics | ||
| Native T1 infarct core, per 10 ms | 0.91 (0.82, 1.00) | 0.061 |
| Current smoking | 5.27 (1.07, 26.00) | 0.041 |
| Sustained ventricular arrhythmia | 16.06 (1.67, 154.43) | 0.016 |
| Incomplete ST-segment resolution | 3.29 (0.85, 12.78) | 0.085 |
| B. Patient and angiographic characteristics and infarct core native T2 | ||
| Native T1 infarct core, per 10 ms | 0.91 (0.81, 1.01) | 0.073 |
| Native T2 infarct core, per 10 ms | 1.01 (0.28, 3.67) | 0.987 |
| Current smoking | 4.99 (0.99, 25.06) | 0.051 |
| Sustained ventricular arrhythmia | 15.26 (1.57, 148.71) | 0.019 |
| Incomplete ST-segment resolution | 3.18 (0.81, 12.43) | 0.097 |
| C. Patient and angiographic characteristics and myocardial haemorrhage | ||
| Native T1 infarct core, per 10 ms | 0.90 (0.81, 1.01) | 0.070 |
| Myocardial haemorrhage | 0.57 (0.14, 2.41) | 0.449 |
| Current smoking | 4.78 (0.83, 27.52) | 0.080 |
| Sustained ventricular arrhythmia | 11.70 (0.94, 144.88) | 0.055 |
| Incomplete ST-segment resolution | 3.68 (0.90, 15.02) | 0.069 |
The odds ratio (95% CIs) indicates the magnitude and direction for adverse LV remodelling. For a 10 ms increase in native T1, the odds ratio for adverse LV remodelling reduced (0.91 (0.82, 1.00); P = 0.061). For a 1 ms increase in native T1, the odds ratio for adverse LV remodelling reduced [0.99 (0.98, 1.00); P = 0.061].
aTwenty clinical characteristics at baseline that were univariable associates of adverse LV remodelling at 6 months post-MI were included in the multivariable model and these univariable associates are described in Supplementary material online, Results. Two hundred and sixty-seven STEMI patients had CMR at 6 months and baseline and 23 of these patients had missing data of at least one of the univariable characteristics that were included in this multivariable model. C-statistic [area-under-the-curve (AUC)] for the multivariable model in 244 subjects but not including native T1 core: 0.95; C-statistic (AUC) for the model (above) including infarct core native T1 (n = 136): 0.81; net reclassification index for incremental addition of T1 core to the model: 0.31, P = 0.184.
When the multivariable model for adverse remodelling included infarct size, the AUC without native T1 core (continuous, ms) was 0.823 and the AUC with T1 core values included was 0.857. Inclusion of native T1 core values neither increased nor reduced the predictive value of this model (net reclassification index P = 0.16).
There was no threshold for native T1 core value in the infarct core in relation to its association with LV outcomes at baseline or during follow-up.