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Impaired LV GCS and GLS strain were significantly associated with increased occurrence of MACE (GCS HR 1.208, 95% CI 1.076 to 1.356, p =0.001; GLS HR 1.362, 95% CI 1.180 to 1.573, p less then 0.001). On multivariable analysis, LV GLS provided incremental prognostic value over late gadolinium enhancement (LGE) and LV ejection fraction (LVEF) (LGE + LVEF chi-square = 12.865, LGE + LVEF + GLS chi-square = 18.459; p =0.012). Patients with GLS ≥-11.5% (above median value) who received early intravenous metoprolol were 64% less likely to