ORIGINAL PAPER Head-to-head comparison of 1 week versus 6 months CMR- derived infarct size for prediction of late events after STEMI Oliver Husser • Jose V. Monmeneu • Clara Bonanad • Cristina Gomez • Fabian Chaustre • Julio Nunez • Maria P. Lopez-Lereu • Gema Minana • Juan Sanchis • Luis Mainar • Vicente Ruiz • Maria J. Forteza • Isabel Trapero • David Moratal • Francisco J. Chorro • Vicente Bodi Received: 12 February 2013 / Accepted: 15 May 2013 / Published online: 4 June 2013 Ó Springer Science+Business Media Dordrecht 2013 Abstract Infarct size (IS) at 1 week after ST-elevation myocardial infarction (MI) diminishes during the first months. The incremental prognostic value of IS regression and of scar size (SS) at 6 months is unknown. We compared cardiovascular magnetic resonance (CMR)-derived IS at 1 week and SS at 6 months after MI for predicting late major adverse cardiac events (MACE). 250 patients underwent CMR at 1 week and 6 months after MI. IS and SS were determined as the extent of transmural late enhancement (in [ 50 % of wall thickness, ETLE). During 163 weeks, 23 late MACE (cardiac death, MI or readmission for heart failure after the 6 months CMR) occurred. Patients with MACE had a larger IS at 1 week (6 [4–9] vs. 3 [1–5], p \ .0001) and a larger SS at 6 months (5 [2–6] vs. 3 [1–5], p = .005) than those without MACE. Late MACE rates in IS[ median were higher at 1 week (14 vs. 4 %, p = .007) and in SS [ median at 6 months (12 vs. 5 %, p = .053). The C-statistic for pre- dicting late MACE of CMR at 1 week and 6 months was comparable (.720 vs. .746, p = .1). Only ETLE at 1 week (HR 1.31 95 % CI [1.14–1.52], p \ .0001, per segment) independently predicted late MACE. CMR-derived SS at 6 months does not offer prognostic value beyond IS at 1 week after MI. The strongest predictor of late MACE is ETLE at 1 week. Keywords Cardiovascular magnetic resonance Á ST-elevation myocardial infarction Á Prognosis Á Late gadolinium enhancement imaging Introduction Cardiovascular magnetic resonance imaging (CMR) allows for a state of the art assessment of patients after ST-elevation myocardial infarction (STEMI) [1, 2]. CMR has shown a unique value for assessing infarct size based on late gadolin- ium enhancement imaging (LGE) [3]. Both a quantitative assessment of infarct size (expressed as percentage of the left ventricle (LV)) as well as a semiquantitative assessment of the number of segments showing transmural necrosis (in [ 50 % of their wall thickness) have been used to predict late systolic recovery and outcome after STEMI [4]. The prognostic value of a CMR examination, carried out in the post-acute phase (around 1 week) after STEMI has been established [5–7]. Among different myocardial infarction parameters, especially Electronic supplementary material The online version of this article (doi:10.1007/s10554-013-0239-1) contains supplementary material, which is available to authorized users. O. Husser (&) Á C. Bonanad Á C. Gomez Á F. Chaustre Á J. Nunez Á G. Minana Á J. Sanchis Á L. Mainar Á V. Ruiz Á M. J. Forteza Á I. Trapero Á F. J. Chorro Á V. Bodi Cardiology Department, Hospital Clinico Universitario, INCLIVA, Universidad de Valencia, Blasco Ibanez 17, 46010 Valencia, Spain e-mail: oliver.husser@gmail.com V. Bodi e-mail: vicentbodi@hotmail.com O. Husser Klinik und Poliklinik fu ¨r Innere Medizin II, University of Regensburg Medical Center, Regensburg, Germany O. Husser Klinik fu ¨r Herz- und Kreislauferkrankungen, Deutsches Herzzentrum Mu ¨nchen, Munich, Germany J. V. Monmeneu Á M. P. Lopez-Lereu ERESA, Valencia, Spain F. Chaustre Á D. Moratal Centro de Biomateriales e Ingenierı ´a Tisular, Universidad Polite ´cnica de Valencia, Valencia, Spain 123 Int J Cardiovasc Imaging (2013) 29:1499–1509 DOI 10.1007/s10554-013-0239-1