The Index of Microcirculatory Resistance Predicts Myocardial Infarction Related to Percutaneous Coronary Intervention

• DOI: 10.1161/circinterventions.112.969048
• Publication Date: 2012-08-09T06:19:10Z
• Authors: Martin K. C. Ng; Andy S. C. Yong; Michael Ho; Maulik G. Shah; Chirapan Chawanta...; Rachel O’Connell; Anthony Keech; Leonard Kritharides; William F. Fearon
• Keywords: Male; Microcirculation; Myocardial Infarction; Comorbidity; Coronary Artery Disease; Middle Aged; Coronary Angiography; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; ROC Curve; Predictive Value of Tests; Risk Factors; Coronary Circulation; Humans; Female; Angioplasty, Balloon, Coronary; Aged

Periprocedural myocardial infarction (MI) occurs in a significant proportion of patients undergoing percutaneous coronary intervention (PCI) and portends poor outcomes. Currently, no clinically applicable method predicts periprocedural MI the cardiac catheterization laboratory before it occurs. We hypothesized that impaired baseline microcirculatory reserve, which reduces ability to tolerate ischemic insults, is risk for index resistance (IMR) measured during PCI can predict occurrence MI.Consecutive elective single lesion left anterior descending artery were recruited. A pressure-temperature sensor wire was used measure IMR PCI. Of 50 studied, 10 had MI. From binary logistic regression analyses all clinical, procedural, physiological parameters, univariable predictors pre-PCI (P=0.003) number stents (P=0.039). Pre-PCI only independent predictor bivariable performed by adjusting each available covariate one at time (all P≤0.02). ≥27 U 80.0% sensitivity 85.0% specificity predicting (C statistic, 0.80; P=0.003). independently associated with 23-fold developing (odds ratio, 22.7; 95% CI, 3.8-133.9).These data suggest status microcirculation plays role determining susceptibility toward The subsequent necrosis may guide adjunctive prevention strategies.