The Index of Microcirculatory Resistance After Primary Percutaneous Coronary Intervention (PCI): A Pooled Analysis of Individual Patient Data
Pooled result · Cardiac deathResult — go to the resultHazard ratio 2.81 95% CI 1.34–5.88Authors' conclusion
In this large, pooled analysis of individual patient data, IMR measured directly after primary PCI in STEMI was an independent predictor of cardiac death.
Study context
- Population
- STEMI patients with index of microcirculatory resistance (IMR) measured directly after primary PCI
- Participants
- 1,265 patients6 cohorts
- Comparison
- IMR >40 vs IMR ≤40 after primary PCI
- Outcome
- Cardiac death using the predefined IMR cutoff of 40
- Follow-up
- Up to 5 years
Methodological detailscollaborative
- Collaborative
Pooled result
Cardiac death
Hazard ratio
2.81
95% CI 1.34–5.88
P = 0.006
By group
IMR >40vs IMR ≤40
HR 2.81 (95% CI 1.34–5.88); P = 0.006
As reported in the abstract
Further pooled results
| Outcome | IMR ≤40 | IMR >40 | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Cardiac death or HF hospitalisation | 4.9% | 8.9% | 1.98 (1.20–3.29) | P = 0.008 | |
| 0.20.5125Hazard ratio (log scale) |
Infarct size (% of LV mass)
P < 0.001
Independent predictors of cardiac death
- IMR was an independent predictor of cardiac death; coronary flow reserve was not
Optimal IMR cutoff for cardiac death
- Optimal cutoff IMR 70, HR
- 4.73 (95% CI: 2.27-9.83; P < 0.001)
Microvascular obstruction and intramyocardial haemorrhage
- More frequent with IMR >40 than IMR ≤40
Original publication
The Index of Microcirculatory Resistance After Primary PCI: A Pooled Analysis of Individual Patient Data. JACC Cardiovasc Interv. Published 9 October 2023. doi:10.
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