New consensus document attempts to streamline MRI protocol after MI

The Centro Nacional de Investigaciones Cardiovasculares (CNIC), a research foundation in Madrid, Spain, has coordinated the first international consensus document to streamline MRI protocol after myocardial infarction in clinical trials and experimental models.

CNIC drafted the document in an effort to streamline the way researchers perform clinical studies involving MRI after MI. Borja Ibanez, MD, PhD, a lead scientist on the project and the clinical research director at CNIC, said in a statement it was important for his colleagues to establish some kind of protocol to ensure researchers are using uniform parameters.

“Consensus documents of this type provide guidelines to ensure consistency in the use of important tools such as this one,” he said. “Currently, many clinical trials use magnetic resonance imaging to assess a principal outcome, but it is very difficult to compare these studies because they use widely different protocols.

“Myocardial infarction affects millions of people in the world every year, and this is therefore a highly active field of research. Because of this, the implications of the new consensus document are enormous.”

The document advises the main outcome parameter in studies assessing new treatments should be absolute infarct size, or the percentage of a patient’s left ventricle that is irreversibly damaged. It also established the recommended timing for MRI after an infarction as between three and seven days—a practical window considering most MI patients remain in the hospital for at least three days following an event. Current evidence suggests that between three and seven days after MI is when magnetic resonance parameters become more stable and are less likely to be affected by activity in the heart.

Ibanez and co-authors outlined the consensus statement in an international meeting that brought together experts from the U.S., Canada, the U.K., France, Germany, Sweden, the Netherlands, Greece, Switzerland, Singapore and Spain. Those experts included Valentin Fuster, MD, PhD, medical director at Mount Sinai Hospital in New York and editor-in-chief of the Journal of the American College of Cardiology

“Magnetic resonance imaging is one of the best methods for studying the heart after an infarction,” Fuster, co-lead on the consensus document alongside Ibanez, said in the statement. “[It] is the ideal method for assessing the effect of new treatments. However, until now the community has lacked consistent recommendations on the specific procedures to follow after an acute myocardial infarction in order to assess the effect of these treatments.”

The full document is available on the JACC website.