Prognostic value of angiographic microvascular resistance in patients with ST-segment elevation myocardial infarction

Qian, Gangzhen; Qin, Haoran; Deng, Dan; Feng, Yue; Zhang, Chao; Qu, Xiaolong; Zhang, Zhihui

doi:10.1016/j.clinsp.2024.100429

Gangzhen Qian

Data curation

Formal analysis

Investigation

Methodology

Visualization

Roles/Writing – original draft

Writing-review & editing

reviewed and given their approval to the final version of the manuscript

Department of Cardiovascular Medicine, Center for Circadian Metabolism and Cardiovascular Disease, Southwest Hospital, Army Medical University, Chongqing, China

1 Drs. Qian and Qin contribute equally to this work.

https://orcid.org/0000-0001-5692-792X

Haoran Qin

Data curation

Formal analysis

Investigation

reviewed and given their approval to the final version of the manuscript

Department of Cardiovascular Medicine, Center for Circadian Metabolism and Cardiovascular Disease, Southwest Hospital, Army Medical University, Chongqing, China

1 Drs. Qian and Qin contribute equally to this work.

https://orcid.org/0009-0008-3569-0925

Dan Deng

Data curation

Investigation

Validation

reviewed and given their approval to the final version of the manuscript

Department of Cardiovascular Medicine, Center for Circadian Metabolism and Cardiovascular Disease, Southwest Hospital, Army Medical University, Chongqing, China

https://orcid.org/0009-0002-1814-5665

Yue Feng

Data curation

Validation

reviewed and given their approval to the final version of the manuscript

Department of Cardiovascular Medicine, Center for Circadian Metabolism and Cardiovascular Disease, Southwest Hospital, Army Medical University, Chongqing, China

https://orcid.org/0000-0001-6411-6035

Chao Zhang

Data curation

Validation

reviewed and given their approval to the final version of the manuscript

Department of Cardiovascular Medicine, Center for Circadian Metabolism and Cardiovascular Disease, Southwest Hospital, Army Medical University, Chongqing, China

https://orcid.org/0009-0005-5164-7888

Xiaolong Qu

Conceptualization

Resources

Supervision

reviewed and given their approval to the final version of the manuscript

Department of Cardiovascular Medicine, Center for Circadian Metabolism and Cardiovascular Disease, Southwest Hospital, Army Medical University, Chongqing, China

https://orcid.org/0009-0005-7303-6412

Zhihui Zhang ^**Corresponding author. E-mail address:xyzpj@tmmu.edu.cn (Z. Zhang).

Conceptualization

Formal analysis

Funding acquisition

Methodology

Writing-review & editing

reviewed and given their approval to the final version of the manuscript

Department of Cardiovascular Medicine, Center for Circadian Metabolism and Cardiovascular Disease, Southwest Hospital, Army Medical University, Chongqing, China

https://orcid.org/0000-0003-3111-2665

*Corresponding author. E-mail address:xyzpj@tmmu.edu.cn (Z. Zhang).

1
Drs. Qian and Qin contribute equally to this work.

Declaration of competing interest

The authors declare no conflicts of interest.

	AMR < 2.55 mmHg*s/cm (n = 107)	AMR ≥ 2.55 mmHg*s/cm (n = 125)	p-value
Admission
Age (year)	61.05 ± 10.86	66.03 ± 11.85	0.001
Male	95 (88.8%)	104 (83.2%)	0.305
Left ventricular ejection fraction (%)	55.96 ± 8.08	55.16 ± 9.70	0.501
Systolic blood pressure (mmHg)	131.34 ± 23.73	130.08 ± 22.14	0.677
Diastolic blood pressure (mmHg)	81.36 ± 15.40	78.66 ± 15.63	0.187
Risk factors
Current smoker	66 (61.7%)	64 (51.2%)	0.141
Hypertension	57 (53.3%)	62 (49.6%)	0.67
Diabetes	32 (29.9%)	40 (32%)	0.841
Hyperlipidemia	41 (38.3%)	57 (45.6%)	0.324
Previous PCI	10 (9.3%)	4 (3.2%)	0.092
Chronic kidney disease	11 (10.3%)	17 (13.6%)	0.568
Laboratory test
High-density lipoprotein cholesterol (mmoL/L)	1.10 ± 0.29	1.15 ± 0.31	0.238
Low-density lipoprotein cholesterol (mmoL/L)	2.92 ± 1.04	2.99 ± 0.96	0.598
Total cholesterol (mmoL/L)	4.93 ± 1.25	5.00 ± 1.21	0.667
Triglycerides (mmoL/L)	2.22 ± 1.77	2.15 ± 1.92	0.769
Non-high-density lipoprotein cholesterol (mmoL/L)	3.83 ± 1.23	3.86 ± 1.20	0.889
Glucose (mmoL/L)	8.75 ± 4.09	8.84 ± 3.68	0.869
eGFR (mL/min/m²)	92.25 ± 24.09	87.12 ± 23.33	0.101
Creatine (µmoL/L)	75.83 ± 23.94	80.21 ± 47.04	0.362
Uric acid (µmoL/L)	372.11 ± 94.99	364.15 ± 101.15	0.539
Urea (mmoL/L)	6.12 ± 1.99	6.39 ± 2.21	0.328
B-type natriuretic peptide (pg/mL)	218.73 ± 464.86	206.68 ± 408.58	0.834
HbA1c (%)	6.48 ± 1.28	6.53 ± 1.27	0.756
Hematocrit (%)	42.76 ± 4.45	42.52 ± 4.46	0.69
Neutrophil/White blood cell	0.76 ± 0.12	0.78 ± 0.11	0.191
Discharge medication
Aspirin	105 (98.1%)	123 (98.4%)	1
P2Y12 inhibitor	107 (100%)	125 (100%)	1
Beta blocker	86 (80.4%)	90 (72%)	0.183
Statins	106 (99.1%)	118 (94.4%)	0.114
RAAS blockade	56 (52.3%)	65 (52%)	1
SGLT2i	14 (13.1%)	8 (6.4%)	0.132
Operational characteristics
Door to wire time (min)	82.54 ± 38.56	83.15 ± 33.05	0.81
Pre-PCI TIMI grade
0	84 (78.5%)	106 (84.8%)	0.448
I	20 (18.7%)	17 (13.6%)
II	3 (2.8%)	2 (1.6%)
Post-PCI TIMI grade
II	0 (0%)	4 (3.2%)	0.174
III	107 (100%)	121 (96.8%)
Trans-radial access	99 (92.5%)	114 (91.2%)	0.9
Glycoprotein IIb/IIIa inhibitor	20 (18.7%)	36 (28.8%)	0.101
Multivessel disease	66 (61.7%)	63 (50.4%)	0.111
Infarcted related artery
LAD	62 (57.9%)	63 (50.4%)	0.045
LCX	5 (4.7%)	18 (14.4%)
RCA	40 (37.4%)	44 (35.2%)
Post-PCI QFR	0.89 ± 0.15	0.96 ± 0.03	<0.001

	Total (n = 232)	AMR < 2.55 mmHg*s/cm (n = 107)	AMR ≥ 2.55 mmHg*s/cm (n = 125)	p-value
All-cause death or readmission for heart faliure	36 (15.5%)	8 (7.5%)	28 (22.4%)	0.003
All-cause death	15 (6.5%)	4 (3.7%)	11 (8.8%)	0.195
Cardiac death	7 (3.0%)	2 (1.9%)	5 (4%)	0.575
Readmission for heart failure	21 (9.1%)	4 (3.7%)	17 (13.6%)	0.017
Any myocardial infarction	3 (1.3%)	0 (0%)	3 (2.4%)	0.303
IRA myocardial infarction	2 (0.9%)	0 (0%)	2 (1.6%)	0.547
Non-IRA myocardial infarction	1 (0.4%)	0 (0%)	1 (0.8%)	1
Readmission for unstable angina	17 (7.3%)	6 (5.6%)	11 (8.8%)	0.498
Any revascularization	11 (4.7%)	3 (2.8%)	8 (6.4%)	0.33

	HR (univariable)	p-value	HR (multivariable)	p-value
AMR ≥ 2.55 mmHg*s/cm	2.91 (1.33‒6.39)	<0.01	2.33 (1.04‒5.21)	0.04
Left ventricular ejection fraction	0.94 (0.91‒0.97)	<0.01	0.96 (0.93‒0.99)	0.01
eGFR	0.98 (0.97‒0.99)	<0.01	0.99 (0.97‒1.02)	0.57
Creatine	1.01 (1.00‒1.01)	<0.01	1.00 (1.00‒1.01)	0.33
Urea	1.17 (1.02‒1.33)	0.02	0.98 (0.80‒1.19)	0.81
Chronic kidney disease	2.68 (1.26‒5.70)	0.01	1.35 (0.37‒4.96)	0.65

[1] *Corresponding author. E-mail address:xyzpj@tmmu.edu.cn (Z. Zhang).

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Prognostic value of angiographic microvascular resistance in patients with ST-segment elevation myocardial infarction

ABSTRACT

Background:

Methods:

Results:

Conclusions:

HIGHLIGHTS