Microcirculatory Dysfunction After Percutaneous Coronary Intervention Predicts the Early Prognosis of Patients With ST-segment Elevation Myocardial Infarction
10.3969/j.issn.1000-3614.2025.09.008
- VernacularTitle:经皮冠状动脉介入治疗术后微循环障碍预测ST段抬高型心肌梗死患者早期预后
- Author:
Guohui CHEN
1
;
Yuxuan ZHANG
;
Abuduwufuer YIDILISI
;
Yiyue ZHENG
;
Delong CHEN
;
Jiacheng FANG
;
Zining CHEN
;
Rui JI
;
Jiamu CHEN
;
Tiesheng NIU
;
Jun PU
;
Jian'an WANG
;
Jun JIANG
Author Information
1. 浙江大学医学院附属第二医院 心内科,杭州 310009;浙江大学医学院附属第二医院 经血管植入器械全国重点实验室,杭州 310009
- Publication Type:Journal Article
- Keywords:
ST-segment elevation myocardial infarction;
index of microcirculatory resistance;
percutaneous coronary intervention;
prognosis
- From:
Chinese Circulation Journal
2025;40(9):892-897
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To explore the predictive value of angiography-derived index of microcirculatory resistance(Angio-IMR)for early prognosis in patients with acute ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods:This multicenter study enrolled 1 629 consecutive STEMI patients who underwent successful PCI at three grade A tertiary hospitals(The Second Affiliated Hospital,Zhejiang University School of Medicine;Shengjing Hospital of China Medical University;Renji Hospital,Shanghai Jiao Tong University School of Medicine)from June 1,2017,to May 31,2020.According to postoperative Angio-IMR,patients was stratified into two groups:the Angio-IMR>40 group(n=508)and the Angio-IMR≤40 group(n=1 121).The incidence of major adverse cardiovascular events(MACE;defined as a composite endpoint including cardiac death,heart failure rehospitalization,cardiogenic shock,malignant arrhythmia,cardiopulmonary resuscitation and stent thrombosis)within 1-month post-PCI was compared between the two groups.Results:The median Angio-IMR after PCI was 32.4(22.3,42.6).The cumulative incidence of early-term MACE was significantly higher in patients with Angio-IMR>40,compared to those with Angio-IMR≤40(5.5%vs.2.3%,log-rank P<0.001).Multivariate Cox regression analysis showed that Angio-IMR>40 was an independent predictor of early-term MACE(HR=2.07,95%CI:1.20-3.58,P=0.009).The addition of Angio-IMR enhanced the predicting performance of the clinical risk model to predict early adverse outcomes(AUC:0.820 vs.0.794,P=0.043).Conclusions:In patients with STEMI after PCI,Angio-IMR can predict the occurrence of early-term MACE.The incorporation of Angio-IMR to clinical models significantly improves the model ability to predict early adverse outcomes in these patients.
