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.
■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。