1018 Safety of cardiovascular magnetic resonance performed immediately after primary percutaneous coronary intervention for ST-elevation myocardial infarction
Bibliographic record
Abstract
After percutaneous coronary intervention (PCI) with stent implantation, cardiovascular magnetic resonance (CMR) is usually postponed in order to prevent theoretical stent heating or displacement. However, several studies have demonstrated CMR safety when performed 3 days after the PCI procedure. In order to better evaluate myocardial perfusion, necrosis and viability in the hyperacute phase of ST elevation myocardial infarction (STEMI), it would be useful to perform CMR more rapidly following coronary stenting. We investigated the early and long term safety of CMR when performed immediately after primary PCI with stenting for STEMI. We prospectively studied 128 patients undergoing primary PCI with stent implantation for STEMI. The study group was composed of 64 patients who underwent CMR (1.5 Tesla) within 12 hours after primary PCI including 105 stents. The control group, also composed of 64 patients, underwent primary PCI without CMR. Adverse events were reported during the early in-hospital period as well as during 6-month follow-up. Patient populations were comparable in both groups. Total ischemic times were similar (CMR+ 4.0 h, CMR- 5.5 h, p = ns), as were peak troponin rise (CMR+ 3.2 μg/L, CMR- 2.3 μg/L, p = ns). The median delay between PCI and CMR was 4.8 (interquartile range 4.1) hours. Duration of the CMR study was 42 (11) minutes and no adverse events occurred during the imaging session. Immediate CMR was not associated with any in-hospital increase in death, myocardial infarction, urgent revascularization, or bleeding (p = ns for each). During 6-month follow-up, CMR performed immediately after primary PCI was not associated with a higher rate adverse events compared to primary PCI without CMR (respectively MACE 5 vs. 8%, p = 0.16; repeat angina 6 vs. 8%, p = 0.73; rehospitalization for cardiac cause 3 vs. 13%, p = 0.05). On Kaplan-Meier estimates, event-free survival at 6 months was not decreased by performing CMR immediately after primary PCI with stenting. Cardiovascular magnetic resonance at 1.5 T performed immediately after primary PCI with coronary stent implantation has proven early and long-term safety, opening the door for improved risk stratification in the hyperacute phase of STEMI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".