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June 23, 2023European Heart JournalOpen Access

Microvascular resistance reserve: diagnostic and prognostic performance in the ILIAS registry

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Why the study?

Microvascular resistance reserve (MRR) was introduced to characterize coronary microcirculation vasodilator capacity accounting for epicardial disease and aortic pressure changes, but its diagnostic and prognostic performance needed evaluation.

Does microvascular resistance reserve (MRR) predict major adverse cardiac events and target vessel failure in patients with stable symptoms undergoing coronary angiography?

Population

1481 patients with stable symptoms and indication for coronary angiography

Comparison

MRR vs CFR across different FFR values

Design

Registry-based cohort study

Follow-up

5 years

Key result

Microvascular resistance reserve (MRR) was independently associated with major adverse cardiac events (MACE) at 5 years (HR 0.78) in patients with significant epicardial disease.

Authors

CBCoen K.M. BoerhoutJLJoo Myung LeeGWGuus A. de Waard

Discussion

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Member takes

Overview

MRR may refine prognostication in stable CAD with epicardial disease; hypothesis-generating and should not yet change practice.

Structured PICO

Does microvascular resistance reserve (MRR) predict major adverse cardiac events and target vessel failure in patients with stable symptoms undergoing coronary angiography?

P
Population
1,481 patients with stable symptoms and a clinical indication for coronary angiography from the global ILIAS Registry
I
Intervention
Microvascular resistance reserve (MRR) assessment
O
Outcome
Major adverse cardiac events (MACE) and target vessel failure (TVF) at 5-year follow-upcomposite

MRR is a robust indicator of microvascular vasodilator reserve capacity and independently predicts 5-year MACE and TVF, offering a diagnostic advantage in patients with hemodynamically significant epicardial coronary artery disease.

Cite This Study

Boerhout et al. (2023) studied this question. Microvascular resistance reserve (MRR) was independently associated with major adverse cardiac events (MACE) at 5 years (HR 0.78) in patients with significant epicardial disease.

synapsesocial.com/papers/696bdcb272d15f53efa1e68chttps://doi.org/10.1093/eurheartj/ehad378
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