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Abstract：
UNASSIGNED: Studies reporting the status of coronary microvascular function in the infarct-related artery (IRA) after primary percutaneous coronary intervention (PCI) remain limited. This study utilized the coronary angiography-derived index of microcirculatory resistance (caIMR) to assess coronary microvascular function in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI.
UNASSIGNED: We used the FlashAngio system to measure the caIMR after primary PCI in 157 patients with STEMI. The primary endpoint was the occurrence of a major adverse cardiovascular event (MACE), defined as a composite endpoint encompassing cardiac mortality, target vessel revascularization, and rehospitalization due to congestive heart failure (CHF), myocardial infarction (MI), or angina.
UNASSIGNED: Approximately 30% of patients diagnosed with STEMI and who experienced successful primary PCI during the study period had a caIMR in the IRA of > 40. The caIMR in the IRA was significantly higher than in the reference vessel (32.9 ± 15.8 vs. 27.4 ± 11.1, p < 0.001). The caIMR in the reference vessel of the caIMR > 40 group was greater than in the caIMR ≤ 40 group (30.9 ± 11.3 vs. 25.9 ± 10.7, p = 0.009). Moreover, the caIMR > 40 group had higher incidence rates of MACEs at 3 months (25.5% vs. 8.3%, p = 0.009) and 1 year (29.8% vs. 13.9%, p = 0.04), than in the caIMR ≤ 40 group, which were mainly driven by a higher rate of rehospitalization due to CHF, MI, or angina. A caIMR in the IRA of > 40 was an independent predictor of a MACE at 3 months (hazard ratio (HR): 3.459, 95% confidence interval (CI): 1.363-8.779, p = 0.009) and 1 year (HR: 2.384, 95% CI: 1.100-5.166, p = 0.03) in patients with STEMI after primary PCI.
UNASSIGNED: Patients with STEMI after primary PCI often have coronary microvascular dysfunction, which is indicated by an increased caIMR in the IRA. An elevated caIMR of > 40 in the IRA was associated with an increased risk of adverse outcomes in STEMI patients undergoing primary PCI.
UNASSIGNED: We used the FlashAngio system to measure the caIMR after primary PCI in 157 patients with STEMI. The primary endpoint was the occurrence of a major adverse cardiovascular event (MACE), defined as a composite endpoint encompassing cardiac mortality, target vessel revascularization, and rehospitalization due to congestive heart failure (CHF), myocardial infarction (MI), or angina.
UNASSIGNED: Approximately 30% of patients diagnosed with STEMI and who experienced successful primary PCI during the study period had a caIMR in the IRA of > 40. The caIMR in the IRA was significantly higher than in the reference vessel (32.9 ± 15.8 vs. 27.4 ± 11.1, p < 0.001). The caIMR in the reference vessel of the caIMR > 40 group was greater than in the caIMR ≤ 40 group (30.9 ± 11.3 vs. 25.9 ± 10.7, p = 0.009). Moreover, the caIMR > 40 group had higher incidence rates of MACEs at 3 months (25.5% vs. 8.3%, p = 0.009) and 1 year (29.8% vs. 13.9%, p = 0.04), than in the caIMR ≤ 40 group, which were mainly driven by a higher rate of rehospitalization due to CHF, MI, or angina. A caIMR in the IRA of > 40 was an independent predictor of a MACE at 3 months (hazard ratio (HR): 3.459, 95% confidence interval (CI): 1.363-8.779, p = 0.009) and 1 year (HR: 2.384, 95% CI: 1.100-5.166, p = 0.03) in patients with STEMI after primary PCI.
UNASSIGNED: Patients with STEMI after primary PCI often have coronary microvascular dysfunction, which is indicated by an increased caIMR in the IRA. An elevated caIMR of > 40 in the IRA was associated with an increased risk of adverse outcomes in STEMI patients undergoing primary PCI.
摘要：
■报告初次经皮冠状动脉介入治疗（PCI）后梗死相关动脉（IRA）的冠状动脉微血管功能状态的研究仍然有限。这项研究利用冠状动脉造影得出的微循环阻力指数（caIMR）来评估接受直接PCI的ST段抬高型心肌梗死（STEMI）患者的冠状动脉微血管功能。
■我们使用FlashAngio系统测量了157例STEMI患者的原发性PCI后的caIMR。主要终点是主要不良心血管事件（MACE）的发生，定义为包括心脏死亡率的复合终点，靶血管血运重建,充血性心力衰竭（CHF）导致的再住院，心肌梗死（MI），或者心绞痛.
■在研究期间诊断为STEMI并经历了成功的直接PCI的患者中，约30%的IRA患者的caIMR>40。IRA中的caIMR明显高于参考血管（32.9±15.8vs.27.4±11.1，p<0.001）。caIMR>40组参考血管的caIMR大于caIMR≤40组(30.9±11.3vs.25.9±10.7，p=0.009）。此外，caIMR>40组3个月时MACEs发生率较高(25.5%vs.8.3%,p=0.009)和1年(29.8%与13.9%,p=0.04),比CAIMR≤40组，这主要是由于CHF导致的再住院率较高，MI,或者心绞痛.IRA>40的caIMR是直接PCI后STEMI患者3个月（风险比（HR）：3.459，95％置信区间（CI）：1.363-8.779，p=0.009）和1年（HR：2.384，95％CI：1.100-5.166，p=0.03）时MACE的独立预测因子。
■直接PCI术后的STEMI患者常出现冠状动脉微血管功能障碍，IRA的caIMR增加表明了这一点。IRA中caIMR>40的升高与接受原发性PCI的STEMI患者的不良结局风险增加相关。
■我们使用FlashAngio系统测量了157例STEMI患者的原发性PCI后的caIMR。主要终点是主要不良心血管事件（MACE）的发生，定义为包括心脏死亡率的复合终点，靶血管血运重建,充血性心力衰竭（CHF）导致的再住院，心肌梗死（MI），或者心绞痛.
■在研究期间诊断为STEMI并经历了成功的直接PCI的患者中，约30%的IRA患者的caIMR>40。IRA中的caIMR明显高于参考血管（32.9±15.8vs.27.4±11.1，p<0.001）。caIMR>40组参考血管的caIMR大于caIMR≤40组(30.9±11.3vs.25.9±10.7，p=0.009）。此外，caIMR>40组3个月时MACEs发生率较高(25.5%vs.8.3%,p=0.009)和1年(29.8%与13.9%,p=0.04),比CAIMR≤40组，这主要是由于CHF导致的再住院率较高，MI,或者心绞痛.IRA>40的caIMR是直接PCI后STEMI患者3个月（风险比（HR）：3.459，95％置信区间（CI）：1.363-8.779，p=0.009）和1年（HR：2.384，95％CI：1.100-5.166，p=0.03）时MACE的独立预测因子。
■直接PCI术后的STEMI患者常出现冠状动脉微血管功能障碍，IRA的caIMR增加表明了这一点。IRA中caIMR>40的升高与接受原发性PCI的STEMI患者的不良结局风险增加相关。
