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Relationship Between Post-Procedural Angiography-Derived Index of Microcirculatory Resistance and Periprocedural
Tetsuya Matsuyama1, Takayuki Okamura1, Tatsuhiro Fujimura1
1Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine Yamaguchi Japan.
Background:
Periprocedural myocardial injury (PMI) is a common complication of percutaneous coronary intervention (PCI). Elevated post-PCI index of microcirculatory resistance (IMR) has been linked to PMI. The angiography-derived IMR (angio-IMR) serves as a pressure-wire-free method to assess coronary microvascular function. This study aimed to establish the association between post-PCI angio-IMR and PMI.
Methods And Results:
We retrospectively analyzed 101 consecutive elective PCI cases where PMI diagnosis and post-PCI angio-IMR calculation were feasible. Angio-IMR was computed using computational flow and pressure simulations. Patients were categorized into 2 groups based on PMI status: PMI (n=33), and non-PMI (n=68). The PMI group had significantly higher post-PCI angio-IMR values than the non-PMI group (31.8±5.9 vs. 23.8±6.0; P<0.001). Both univariate and multivariate logistic regression analyses revealed an association between post-PCI angio-IMR and PMI. Patients with post-PCI angio-IMR ≥29 had a significantly higher incidence of PMI (67.6% vs. 12.5%; P<0.001).
Conclusions:
Increased post-PCI angio-IMR values were strongly associated with PMI. Post-PCI angio-IMR might serve as a useful non-invasive predictive of PMI following elective PCI.
Insights
Elevated angiography-derived index of microcirculatory resistance (angio-IMR) after percutaneous coronary intervention (PCI) is linked to periprocedural myocardial injury (PMI). This non-invasive measure may predict PMI risk in patients undergoing elective PCI.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiovascular Research
Background:
- Periprocedural myocardial injury (PMI) is a frequent complication following percutaneous coronary intervention (PCI).
- Elevated index of microcirculatory resistance (IMR) post-PCI is associated with PMI.
- Angiography-derived IMR (angio-IMR) offers a pressure-wire-free assessment of coronary microvascular function.
Purpose of the Study:
- To determine the association between post-PCI angio-IMR and PMI.
- To evaluate angio-IMR as a potential non-invasive predictor of PMI.
Main Methods:
- Retrospective analysis of 101 elective PCI cases.
- Calculation of post-PCI angio-IMR using computational flow and pressure simulations.
- Comparison of angio-IMR values between patients with and without PMI.
Main Results:
- Patients with PMI exhibited significantly higher post-PCI angio-IMR values compared to those without PMI (31.8±5.9 vs. 23.8±6.0; P<0.001).
- Logistic regression confirmed a significant association between post-PCI angio-IMR and PMI.
- A post-PCI angio-IMR threshold of ≥29 was associated with a substantially higher incidence of PMI (67.6% vs. 12.5%; P<0.001).
Conclusions:
- Higher post-PCI angio-IMR values are strongly correlated with PMI.
- Post-PCI angio-IMR shows promise as a non-invasive tool for predicting PMI after elective PCI.
