Open Access
Open access
Ovid Technologies (Wolters Kluwer Health)
Journal of the American Heart Association
,  том 14 ,  издание 4

Microcirculatory Resistance After Primary Percutaneous Coronary Intervention Predicts Residual Myocardial Damage and Scar Formation

Alessandro Candreva 1, 2
, 
Alexander Gotschy 1, 3, 4
, 
Julia Stehli 1
, 
Lea Bissig 1
, 
Maurizio Lodi Rizzini 2
, 
Claudio Chiastra 2
, 
Diego Gallo 2
, 
Umberto Morbiducci 2
, 
Roland Klingenberg 5
, 
Dik Heg 6
, 
CM Matter 1
, 
Frank Ruschitzka 1
, 
Robert Manka 1, 3, 4
, 
Barbara E. Stähli 1
1
 
2
 
3
 
4
 
5
 
6
 
Тип публикации: Journal Article
Дата публикации: 2025-02-18
Ovid Technologies (Wolters Kluwer Health)
scimago Q1
wos Q1
БС1
SJR: 2.189
CiteScore: 8.5
Impact factor: 5.3
ISSN: 20479980
Краткое описание
Background
Coronary microvascular dysfunction has been associated with adverse cardiovascular events following acute myocardial infarction. This study evaluates the role of the angiography‐derived index of microcirculatory resistance (angio‐IMR) in predicting myocardial damage in patients with ST‐segment–elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI).
Methods and Results
In this post hoc analysis of the CLEVER‐ACS (Controlled‐Level Everolimus in Acute Coronary Syndromes) trial, the associations between post‐PCI angio‐IMR of infarct‐related coronary arteries (IRAs) and infarct size, microvascular obstruction, and left ventricular ejection fraction at 30 days as assessed by cardiac magnetic resonance were investigated. High post‐PCI angio‐IMR was defined as ≥40 mm Hg*s . In non‐IRAs, angio‐IMR was measured before IRA‐PCI. A total of 52 IRAs and 94 non‐IRAs of 52 patients were analyzed. Post‐PCI angio‐IMR was 41.5 (interquartile range [IQR], 28.5–55.7) mm Hg*s  in IRAs and pre‐PCI angio‐IMR was 43.7 (IQR, 31.7–54.0) mm Hg*s in non‐IRAs ( P =0.70). Patients with high post‐PCI angio‐IMR (52%) exhibited a larger myocardial infarct size (36.0 [IQR, 23.0–52.5] g versus 14.5 [IQR, 6.50–26.5] g, P <0.001) and a lower left ventricular ejection fraction (46.5% [IQR, 39.5%–49.5%] versus 55.0% [IQR, 48.0%–61.4%], P =0.002) at 30 days as compared with those with low post‐PCI angio‐IMR values. Post‐PCI angio‐IMR positively correlated with myocardial infarct size (r=0.45, P =0.001) and extent of microvascular obstruction (r=0.40, P =0.004) at 30 days. Post‐PCI angio‐IMR predicted myocardial infarct size (area under the curve, 0.78 [IQR, 0.65–0.92]; P =0.001) and extent of microvascular obstruction (area under the curve, 0.74 [IQR, 0.60–0.89]; P =0.009) at 30 days.
Conclusions
In patients with ST‐segment–elevation myocardial infarction, post‐PCI angio‐IMR was identified as independent predictor of myocardial infarct size and extent of microvascular obstruction.
Registration
URL: https:// clinicaltrials.gov ; Unique Identifier: NCT01529554.
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Candreva A. et al. Microcirculatory Resistance After Primary Percutaneous Coronary Intervention Predicts Residual Myocardial Damage and Scar Formation // Journal of the American Heart Association. 2025. Vol. 14. No. 4.
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Candreva A., Gotschy A., Stehli J., Bissig L., Lodi Rizzini M., Chiastra C., Gallo D., Morbiducci U., Klingenberg R., Heg D., Matter C., Ruschitzka F., Manka R., Stähli B. E. Microcirculatory Resistance After Primary Percutaneous Coronary Intervention Predicts Residual Myocardial Damage and Scar Formation // Journal of the American Heart Association. 2025. Vol. 14. No. 4.
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TY - JOUR
DO - 10.1161/jaha.124.036033
UR - https://www.ahajournals.org/doi/10.1161/JAHA.124.036033
TI - Microcirculatory Resistance After Primary Percutaneous Coronary Intervention Predicts Residual Myocardial Damage and Scar Formation
T2 - Journal of the American Heart Association
AU - Candreva, Alessandro
AU - Gotschy, Alexander
AU - Stehli, Julia
AU - Bissig, Lea
AU - Lodi Rizzini, Maurizio
AU - Chiastra, Claudio
AU - Gallo, Diego
AU - Morbiducci, Umberto
AU - Klingenberg, Roland
AU - Heg, Dik
AU - Matter, CM
AU - Ruschitzka, Frank
AU - Manka, Robert
AU - Stähli, Barbara E.
PY - 2025
DA - 2025/02/18
PB - Ovid Technologies (Wolters Kluwer Health)
IS - 4
VL - 14
SN - 2047-9980
ER -
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@article{2025_Candreva,
author = {Alessandro Candreva and Alexander Gotschy and Julia Stehli and Lea Bissig and Maurizio Lodi Rizzini and Claudio Chiastra and Diego Gallo and Umberto Morbiducci and Roland Klingenberg and Dik Heg and CM Matter and Frank Ruschitzka and Robert Manka and Barbara E. Stähli},
title = {Microcirculatory Resistance After Primary Percutaneous Coronary Intervention Predicts Residual Myocardial Damage and Scar Formation},
journal = {Journal of the American Heart Association},
year = {2025},
volume = {14},
publisher = {Ovid Technologies (Wolters Kluwer Health)},
month = {feb},
url = {https://www.ahajournals.org/doi/10.1161/JAHA.124.036033},
number = {4},
doi = {10.1161/jaha.124.036033}
}