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Prognostic impact of coronary microvascular dysfunction in patients with myocardial infarction evaluated by new angiography-derived index of microvascular resistance

Authors :
Benoit Caullery
Laurent Riou
Stephanie Marliere
Estelle Vautrin
Nicolas Piliero
Olivier Ormerzzano
Helene Bouvaist
Gerald Vanzetto
Gilles Barone-Rochette
Source :
International Journal of Cardiology: Heart & Vasculature, Vol 56, Iss , Pp 101575- (2025)
Publication Year :
2025
Publisher :
Elsevier, 2025.

Abstract

Background: Several methods for measuring IMR derived from angiography have been developed. AngioIMR is a novel method for the assessment of angiography-derived IMR with no requirement for a wire and hyperemia. The prognostic value of AngioIMR is unknown in STEMI patients. We aimed to provide the prognostic value of AngioIMR in patients with ST-elevation myocardial infarction (STEMI). Methods: This study included patients with STEMI who underwent invasive coronary angiography and primary percutaneous coronary intervention (PPCI). AngioIMR was calculated using computational flow and pressure simulation immediately after PPCI. The presence of significant coronary microvascular dysfunction was defined as AngioIMR > 40. The primary outcome was a composite of all cause death or hospitalization for heart failure (MACE). Results: A total of 178 patients were included (65.0 ± 12.8 years on average, 74 % male gender). An AngioIMR > 40 was found in 72 patients. During a median follow-up of 2.9 (2.3–6.9) years, a primary endpoint was observed in 56 patients. By Kaplan-Meier analysis, the risk of MACE was significantly higher in patients with AngioIMR > 40 (log-rank P < 0.01). An Angio IMR > 40 was significantly associated with the occurrence of the primary endpoint in univariate (70 % vs 27 %; hazard ratio 4.519; 95 % CI: 2.550–8.009; p

Details

Language :
English
ISSN :
23529067
Volume :
56
Issue :
101575-
Database :
Directory of Open Access Journals
Journal :
International Journal of Cardiology: Heart & Vasculature
Publication Type :
Academic Journal
Accession number :
edsdoj.07e0d65afaf7488c9853d4bab5766c94
Document Type :
article
Full Text :
https://doi.org/10.1016/j.ijcha.2024.101575