Coronary disease & ACS

Prognostic Value of Coronary Angiography-Derived Index of Microcirculatory Resistance in Patients With Intermediate Coronary Stenosis

JACC Cardiovasc IntervPublished Post hoc analysis of the FLAVOUR randomised trial

Authors' conclusion

In individuals with intermediate coronary stenosis, elevated angio-IMR is linked to an adverse prognosis.

Study context

Population
Patients with intermediate coronary stenosis (FLAVOUR trial)
Participants
1,658 patients
Comparison
Angio-IMR >25 vs angio-IMR ≤25
Primary endpoint
Patient-oriented composite outcome (POCO):
  • All-cause death
  • MI
  • Revascularization
Follow-up
2 years
Methodological detailsMedian follow-up 24.8 months (Q1-Q3: 24.4-26.4 months)
  • Median follow-up 24.8 months (Q1-Q3: 24.4-26.4 months)

Primary result

As reported in the abstract

POCO

Angio-IMR >25

Percutaneous coronary intervention (PCI)
35.06% [27 of 77]
Non-PCI
17.95% [21 of 117]

Angio-IMR ≤25

PCI
7.2% [51 of 708]
Non-PCI
4.23% [32 of 756]

Percutaneous coronary intervention (PCI)

Angio-IMR >2535.06% [27 of 77]
Angio-IMR ≤257.2% [51 of 708]

Non-PCI

Angio-IMR >2517.95% [21 of 117]
Angio-IMR ≤254.23% [32 of 756]
Angio-IMR >25 vs Angio-IMR ≤25Hazard ratio (95% CI)P value
PCI, adjusted
6.235(3.811–10.203)
P < 0.001
non-PCI, adjusted
5.282(2.948–9.462)
P < 0.001

Further findings

OutcomeC-indexP value
Incremental prognostic value of adding angio-IMRAngiographic model + angio-IMR vs Angiographic model0.710 vs 0.615P < 0.001
Incremental prognostic value of adding angio-IMRClinical model + angio-IMR vs Clinical model0.705 vs 0.594P < 0.001
  • Incremental prognostic value of adding angio-IMR: 95% CI 0.663-0.756 vs 0.563-0.664; NRI 0.268 (0.191-0.362); IDI 0.055 (0.030-0.108)
  • Incremental prognostic value of adding angio-IMR: 95% CI 0.658-0.751 vs 0.544-0.644; NRI 0.268 (0.171-0.350); IDI 0.057 (0.027-0.102)

Original publication

Prognostic Value of Coronary Angiography-Derived Index of Microcirculatory Resistance in Patients With Intermediate Coronary Stenosis. JACC Cardiovasc Interv. Published 27 January 2025. doi:10.1016/j.jcin.2024.10.017

Summarised from the published abstract; every number is checked against it

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