Coronary angiography-derived index of microcirculatory resistance and evolution of infarct pathology after ST-segment-elevation myocardial infarction
Main finding · Final infarct size >25%Result — go to the resultAdjusted odds ratio 3.00 95% CI 1.23–7.32Authors' conclusion
Angio-IMR immediately post-PPCI showed a significant association with the extent and evolution of infarct pathology. An angio-IMR >40 U indicated extensive microvascular damage with less regression of infarct size and more persistent iron at follow-up.
Study context
- Population
- STEMI patients undergoing primary percutaneous coronary intervention (PPCI) with angio-IMR and baseline cardiac magnetic resonance (CMR), enrolled October 2019–August 2021mean age 57.8 years, 84.3% men
- Participants
- 286 patients
- Exposure
- Angio-IMR >40 U vs angio-IMR ≤40 U after PPCI
- Angio-IMR >40 Un = 84
- Outcome
- Evolution of infarct pathology on CMR
- Follow-up
- 3-month follow-up
Methodological detailsCMR at median 3.6 days and 3 months
- CMR at median 3.6 days and 3 months
Main finding
Final infarct size >25%
Adjusted odds ratio
3.00
95% CI 1.23–7.32
P = 0.016
Angio-IMR >40 U vs Angio-IMR ≤40 U
adjusted OR 3.00 (95% CI 1.23–7.32); P = 0.016
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted OR (95% CI) | P value | |
|---|---|---|---|
| Myocardial iron at follow-upAngio-IMR >40 U vs Angio-IMR ≤40 U · presence | 5.52 (1.65–18.51) | P = 0.006 | |
| 0.050.21520Adjusted odds ratio (log scale) |
| Outcome | Beta coefficient (95% CI) | P value |
|---|---|---|
| Myocardial iron at follow-upAngio-IMR >40 U vs Angio-IMR ≤40 U · extent | 0.27 (0.01–0.53) | P = 0.041 |
MVO
- Higher prevalence and extent of MVO with angio-IMR >40 U
Original publication
Coronary angiography-derived index of microcirculatory resistance and evolution of infarct pathology after ST-segment-elevation myocardial infarction. Eur Heart J Cardiovasc Imaging. Published 15 June 2023. doi:10.
Summarised from the published abstract; every number is checked against it