The Impact of Microvascular Resistance Reserve on the Outcome of Patients With STEMI
Main finding · MACCEResult — go to the resultHazard ratio 0.45 per unit increase 95% CI 0.31–0.67Authors' conclusion
The novel parameter MRR is a prognostic marker of MACCEs in STEMI patients with a comparable performance to CFR and IMR.
Study context
- Population
- STEMI patients with multivessel disease after successful revascularization, with coronary physiology (bolus thermodilution) at 3 months
- Participants
- 210 patients
- Exposure
- Coronary microvascular dysfunction (CMD) vs no CMD
- CMDn = 56
- Outcome
- MACCE; prevalence of CMD (MRR <3)
- Follow-up
- 12 months
Main finding
MACCE
Hazard ratio
0.45 per unit increase
95% CI 0.31–0.67
P < 0.001
By group
MRR
HR 0.45 per unit increase (95% CI 0.31–0.67); P < 0.001
Per unit increase, as printed
As reported in the abstract
- CMD prevalence at 3 months
- 56 patients (27%)
Observational data: associations, not effects.
Further findings
| Outcome | FFR | CFR | IMR | MRR |
|---|---|---|---|---|
| AUC for predicting 12-month MACCE | ||||
| AUC | 0.609 | 0.762 | 0.781 | 0.743 |
Stroke, HF, recovery of LV systolic function
- Microvascular resistance reserve (MRR) independently associated with stroke, HF and poorer recovery of LV systolic function
AUC for predicting 12-month MACCE
- Prognostic performance of coronary flow reserve (CFR), index of microvascular resistance (IMR) and MRR comparable
Original publication
The Impact of Microvascular Resistance Reserve on the Outcome of Patients With STEMI. JACC Cardiovasc Interv. Published 14 May 2024. doi:10.
Summarised from the published abstract; every number is checked against it