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Peripheral microvascular function and long-term cardiovascular outcomes after percutaneous coronary intervention in

Ya-Wen Lu1,2,3,4, Chuan-Tsai Tsai3,4,5, Chun-Chin Chang3,4,5

  • 1Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan.

International Journal of Cardiology. Heart & Vasculature
|July 24, 2026
PubMed

Insights

Impaired skin post-occlusive reactive hyperemia (PORH) indicates higher cardiovascular event risk in obstructive coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI). This microvascular assessment may improve risk stratification for better patient outcomes.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Medical Diagnostics

Background:

  • Percutaneous coronary intervention (PCI) advances haven't eliminated recurrent ischemic events in obstructive coronary artery disease (CAD).
  • Skin post-occlusive reactive hyperemia (PORH) assesses systemic microvascular function noninvasively.
  • The prognostic value of skin PORH for long-term outcomes post-PCI is not well-established.

Purpose of the Study:

  • To investigate the association between baseline skin PORH response and long-term cardiovascular outcomes in patients with obstructive CAD undergoing PCI.
  • To determine if skin microvascular function adds prognostic information beyond epicardial coronary anatomy.

Main Methods:

  • Retrospective analysis of 197 obstructive CAD patients from a prospectively established registry.
  • Baseline skin PORH response assessed prior to PCI.
  • Long-term composite cardiovascular outcomes evaluated up to 5 years using Kaplan-Meier and Cox regression, with propensity score matching.

Main Results:

  • Lower PORH index correlated with more cardiometabolic comorbidities and higher long-term cardiovascular event rates.
  • A higher PORH index was independently associated with a lower risk of composite cardiovascular events (aHR, 0.422).
  • This inverse association remained significant in the propensity score-matched cohort.

Conclusions:

  • Impaired skin PORH is an independent predictor of increased long-term cardiovascular events in obstructive CAD patients post-PCI.
  • Skin microvascular assessment via PORH may enhance cardiovascular risk stratification.
  • Further validation in larger prospective studies is warranted.
Abstract

Keywords:
Obstructive coronary artery diseasePercutaneous coronary interventionPost occlusive reactive hyperaemiaSkin microvascular function

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