An angiographic microvascular resistance index >250 was associated with significantly lower event-free survival for major adverse cardiovascular events compared to ≤250 (62.9% vs 75.1%; HR 1.94).
Cohort (n=335)
No
Does an angiographic microvascular resistance (AMR) > 250 predict major adverse cardiovascular events in patients undergoing transcatheter aortic valve replacement?
An angiographic microvascular resistance (AMR) > 250 is an independent predictor of adverse clinical outcomes after transcatheter aortic valve replacement.
Effect estimate: HR 1.94 (95% CI 1.34-2.81)
Absolute Event Rate: 62.9% vs 75.1%
p-value: p=<0.001
Background The coronary microcirculatory resistance index plays a crucial role in predicting patient prognosis. Coronary angiography‐based methods for assessing coronary microcirculatory function offer advantages such as simplicity and cost‐effectiveness. This study aimed to confirm the prognostic value of a novel angiographic microvascular resistance (AMR) index in patients undergoing transcatheter aortic valve replacement. Methods and Results We prospectively included 335 patients with severe aortic stenosis who underwent transcatheter aortic valve replacement at Fuwai Hospital. The AMR was calculated based on coronary angiography performed before prosthetic valve implantation. Patients were divided into 2 groups based on an AMR cutoff value of 250: AMR ≤250 and AMR >250. The primary end point was major adverse cardiovascular events, defined as a composite of all‐cause mortality, readmission for heart failure, and myocardial infarction. At a median follow‐up of 40 months (interquartile range IQR, 25–50), AMR was significantly higher in patients who experienced the primary end point (257 IQR, 186–299 versus 226 IQR, 177–264; P 250 had significantly lower event‐free survival rates for major adverse cardiovascular events (62.9% versus 75.1%; hazard ratio, 1.94 95% CI, 1.34–2.81; log‐rank P 250 can be used as a novel indicator for long‐term prognostic management.
Shi et al. (Mon,) conducted a cohort in Severe aortic stenosis undergoing transcatheter aortic valve replacement (n=335). Angiographic microvascular resistance (AMR) >250 vs. AMR ≤250 was evaluated on Major adverse cardiovascular events (composite of all-cause mortality, readmission for heart failure, and myocardial infarction) (HR 1.94, 95% CI 1.34-2.81, p=<0.001). An angiographic microvascular resistance index >250 was associated with significantly lower event-free survival for major adverse cardiovascular events compared to ≤250 (62.9% vs 75.1%; HR 1.94).