[Safety of early cardiac magnetic resonance imaging in acute myocardial infarction patients with stents]. / Seguridad de la realización precoz de un estudio de resonancia magnética cardiaca en pacientes con infarto agudo de miocardio y revascularización con stent.

INTRODUCTION AND OBJECTIVES: In general, magnetic resonance imaging is contraindicated when the patient has a ferromagnetic prosthesis or implant. With coronary stents, there is a theoretical concern that use of magnetic resonance imaging shortly after implantation will dislodge the stent, thereby increasing the risk of thrombosis. However, the risk may be overestimated because modern coronary stents are not ferromagnetic or are only weakly so. The objective of this study was to determine whether carrying out cardiac magnetic resonance imaging shortly after stent implantation is a safe procedure in acute myocardial infarction patients. METHODS: We carried out a retrospective study of 407 patients with ST-elevation acute myocardial infarction who were treated by stent implantation. Cardiac magnetic resonance imaging was performed in the first 14 (11) days after stent implantation in 86 of these 407 patients (group 1); it was not performed in the 321 patients in group 2. The occurrence of an adverse event, such as death, reinfarction, or revascularization, either in hospital or after 6 or 12 months was recorded. RESULTS: Three patients experienced subacute stent thrombosis, all in group 2. No statistically significant difference in any other variable was found. The combined rate of death, reinfarction, revascularization, or rehospitalization at 12 months was 14% in group 1 and 16% in group 2 (P=.7). CONCLUSIONS: Carrying out cardiac magnetic resonance imaging shortly after stent implantation in acute myocardial infarction patients appears to be a safe procedure.

Seguridad de la realización precoz de un estudio de resonancia magnética cardiaca en pacientes con infarto agudo de miocardio y revascularización con stent / Safety of early cardiac magnetic resonance imaging in acute myocardial infarction patients with stents

Introducción y objetivos. La resonancia magnética está de forma general contraindicada cuando hay algún tipo de prótesis o implante de metal ferromagnético. En el caso del stent coronario, hay una teórica preocupación de que la realización precoz de una resonancia magnética produzca desplazamiento del stent, lo que aumentaría el riesgo de trombosis. Este riesgo puede estar sobrestimado, ya que los stents de última generación no son ferromagnéticos o lo son muy poco. El objetivo de este estudio es comprobar si la realización precoz de una resonancia cardiaca tras el implante de stent es un procedimiento seguro para el paciente tras un infarto agudo de miocardio. Métodos. Estudio retrospectivo de 407 pacientes con infarto agudo de miocardio con elevación del segmento ST tratados con stent. Se realizó un estudio de resonancia cardiaca en los primeros 14 ± 11 días en 86 pacientes (grupo 1); el grupo 2 está formado por los 321 restantes. Se realizó un seguimiento de eventos adversos, incluidos el reinfarto, la muerte o la revascularización intrahospitalaria, y a los 6 y 12 meses. Resultados. Se registraron 3 casos de oclusión trombótica subaguda del stent, todos en el grupo 2. No se encontraron diferencias significativas para el resto de las variables. El evento combinado muerte, reinfarto, revascularización y rehospitalización al año fue del 14% en el grupo 1 y del 16% en el grupo 2 (p = 0,7). Conclusiones. La realización precoz de un estudio con resonancia magnética cardiaca parece ser un procedimiento seguro en pacientes que han sido tratados mediante implante de stent tras un infarto agudo de miocardio

Introduction and objectives. In general, magnetic resonance imaging is contraindicated when the patient has a ferromagnetic prosthesis or implant. With coronary stents, there is a theoretical concern that use of magnetic resonance imaging shortly after implantation will dislodge the stent, thereby increasing the risk of thrombosis. However, the risk may be overestimated because modern coronary stents are not ferromagnetic or are only weakly so. The objective of this study was to determine whether carrying out cardiac magnetic resonance imaging shortly after stent implantation is a safe procedure in acute myocardial infarction patients. Methods. We carried out a retrospective study of 407 patients with ST-elevation acute myocardial infarction who were treated by stent implantation. Cardiac magnetic resonance imaging was performed in the first 14 (11) days after stent implantation in 86 of these 407 patients (group 1); it was not performed in the 321 patients in group 2. The occurrence of an adverse event, such as death, reinfarction, or revascularization, either in hospital or after 6 or 12 months was recorded. Results. Three patients experienced subacute stent thrombosis, all in group 2. No statistically significant difference in any other variable was found. The combined rate of death, reinfarction, revascularization, or rehospitalization at 12 months was 14% in group 1 and 16% in group 2 (P=.7). Conclusions. Carrying out cardiac magnetic resonance imaging shortly after stent implantation in acute myocardial infarction patients appears to be a safe procedure