Index of microcirculatory resistance significantly correlated with peak creatinine kinase (R=0.61, p=0.0005) and 3-month wall motion score (R=0.59, p=0.002) in STEMI patients after primary PCI.
Observational (n=29)
Does the index of microcirculatory resistance (IMR) predict microvascular damage and left ventricular function recovery better than standard measures in patients undergoing primary PCI for STEMI?
IMR measured after primary PCI for STEMI is a strong predictor of acute microvascular damage and short-term left ventricular functional recovery, outperforming standard measures.
Effect estimate: R 0.61 for peak CK; R 0.59 for WMS
p-value: p=0.0005 for peak CK; 0.002 for WMS
OBJECTIVES: The objective of this study is to evaluate the predictive value of the index of microcirculatory resistance (IMR) in patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Despite adequate epicardial artery reperfusion, a number of patients with STEMI have a poor prognosis because of microvascular damage. Assessing the status of the microvasculature in this setting remains challenging. METHODS: In 29 patients after primary PCI for STEMI, IMR was measured with a pressure sensor/thermistor-tipped guidewire. The Thrombolysis In Myocardial Infarction (TIMI) myocardial perfusion grade, TIMI frame count, coronary flow reserve, and ST-segment resolution were also recorded. RESULTS: The IMR correlated significantly with the peak creatinine kinase (CK) (R = 0.61, p = 0.0005) while the other measures of microvascular dysfunction did not. In patients with an IMR greater than the median value of 32 U, the peak CK was significantly higher compared with those having values 32 U compared with <or=32 U (28 +/- 7 vs. 20 +/- 4, p = 0.001). On multivariate analysis, IMR was the strongest predictor of peak CK and 3-month WMS. The IMR was the only significant predictor of recovery of left ventricular function on the basis of the percent change in WMS (R = 0.50, p < 0.01). CONCLUSIONS: Compared to standard measures, IMR appears to be a better predictor of microvascular damage after STEMI, both acutely and in short term follow-up.
Fearon et al. (Thu,) conducted a observational in ST-segment elevation myocardial infarction (STEMI) (n=29). Index of microcirculatory resistance (IMR) vs. Standard measures of microvascular dysfunction was evaluated on Peak creatinine kinase (CK) and 3-month echocardiographic wall motion score (WMS) (R 0.61 for peak CK; R 0.59 for WMS, p=0.0005 for peak CK; 0.002 for WMS). Index of microcirculatory resistance significantly correlated with peak creatinine kinase (R=0.61, p=0.0005) and 3-month wall motion score (R=0.59, p=0.002) in STEMI patients after primary PCI.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: