Key result
Anterior STEMI is linked to ~5.5-fold higher odds of post-PCI coronary microcirculatory dysfunction.
Why the study?
The study aimed to identify factors associated with coronary microcirculatory dysfunction evaluated by myocardial contrast echocardiography in patients with STEMI after emergency revascularization.
What clinical, laboratory, and echocardiographic factors are independently associated with coronary microcirculatory dysfunction as evaluated by myocardial contrast echocardiography within 24 hours after emergency PCI in patients with acute STEMI?
Observational (n=144)
No
What clinical, laboratory, and echocardiographic factors are independently associated with coronary microcirculatory dysfunction as evaluated by myocardial contrast echocardiography within 24 hours after emergency PCI in patients with acute STEMI?
In patients with STEMI undergoing emergency PCI, elevated neutrophil count (≥8.61 ×10⁹/L) and anterior wall infarction independently predict early coronary microcirculatory dysfunction as detected by bedside myocardial contrast echocardiography.
Objective: To identify factors associated with coronary microcirculatory dysfunction(CMD), as evaluated by myocardial contrast echocardiography(MCE), in patients with ST-segment elevation myocardial infarction(STEMI) after emergency revascularization. Methodology: A total of 144 consecutive patients with STEMI who underwent percutaneous coronary intervention (PCI) at the Department of Cardiology, the Second Hospital of Hebei Medical University between January 2022 to December 2024 were retrospectively enrolled, comprising 70 in the CMD group(62 men, 88.6%) and 74 in the normal group (65 men, 87.8%) based on MCE findings, MCE was performed within 24 hours after PCI. Clinical characteristics, MCE, and coronary angiography were collected and compared between groups. Multivariable logistic regression analysis(backward stepwise) was applied to determine independent predictors of post-PCI CMD. Results: Anterior wall myocardial infarction (AWMI) was found in 59 (84.3%) patients in the CMD group and 37 (50%) in the normal group (P< 0.001). Total protein levels were modestly but significantly increased in patients with CMD. TTE assessment showed a lower ratio of early to late diastolic transmitral flow velocities in the CMD group. The myocardial perfusion score index was markedly elevated in the CMD group. Regarding infarct-related arteries, the left anterior descending artery was more frequently involved in the CMD group, whereas involvement of the right coronary artery was less common. Multivariable logistic regression identified NE ≥8.61 ×10⁹/L and AWMI as independent risk factors of post-PCI CMD in patients with STEMI. Conclusion: NE ≥8.61 ×10⁹/L and AWMI appear to independently predict the development of CMD in patients with STEMI.
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Meng et al. (2026) conducted an observational in Acute ST-segment elevation myocardial infarction (STEMI) (n=144). Anterior wall myocardial infarction (AWMI) and elevated neutrophil count (NE ≥8.61 ×10⁹/L) vs. Inferior wall myocardial infarction and neutrophil count <8.61 ×10⁹/L was evaluated on Post-PCI coronary microcirculatory dysfunction (CMD) defined as myocardial perfusion score index (MPSI) > 1.0 on MCE (OR 5.466, 95% CI 2.408–12.410, p=<0.001). Anterior wall myocardial infarction (OR 5.466, p<0.001) and neutrophil count ≥8.61 ×10⁹/L (OR 3.207, p=0.002) independently predicted post-PCI coronary microcirculatory dysfunction in STEMI patients.
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