| The index of microvascular resistance identifies patients with periprocedural myocardial infarction in elective percutaneous coronary intervention. | |
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MedLine Citation:
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PMID: 22895644 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: This study was designed to assess whether measurement of the index of microvascular resistance (IMR) could help prospectively identify patients who develop periprocedural myocardial infarction (PPMI). METHODS AND RESULTS: IMR was measured in 54 patients before and following percutaneous coronary intervention (PCI) in a culprit vessel with a PressureWire using the equation IMR = Pa(Hyp) × Tmn(Hyp) (Pd(Hyp)-Pw/Pa(Hyp)-Pw). IMR was also measured in an angiographically normal reference vessel. The relative pre-IMR ratio (rPIMR) defined as IMR Culprit divided by IMR Non-Culprit was also calculated. Troponin was sequentially sampled up to 24 h following PCI. Mean troponin post-PCI was 0.37±0.8 ng/ml. 33 (61%) patients fulfilled the criteria for PPMI. IMR pre-PCI was the most significant correlate of post-PCI troponin (r=0.43 p=0.001), however, the number of balloon inflations (r=0.3, p=0.02) and rPIMR (r=0.33 p=0.017) were also correlated. IMR pre-PCI was higher in patients with periprocedural myocardial infarction compared with patients without PPMI (IMR pre-PCI 21.2±2.1 PPMI vs 15.6±1.8 No PPMI, p=0.02). The strongest predictor of troponin post-PCI was IMR pre-PCI (β 0.7, p=0.02). Both IMR pre- and rPIMR were predictive of PPMI (OR 11 (1.3 to 90.5) p=0.026, OR 1.09 (1 to 1.19) p=0.03, respectively). CONCLUSION: Microvascular function prior to PCI is an important determinant of PPMI. Measuring IMR pre-PCI and rPIMR may allow prospective identification of patients at risk of periprocedural myocardial infarction. Future studies in a larger cohort are required to establish the predictive ability of IMR in PPMI. |
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Authors:
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Jamie J Layland; Robert J Whitbourn; Andrew T Burns; Jithendra Somaratne; Georg Leitl; Andrew I Macisaac; Andrew Wilson |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-8-15 |
Journal Detail:
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Title: Heart (British Cardiac Society) Volume: - ISSN: 1468-201X ISO Abbreviation: Heart Publication Date: 2012 Aug |
Date Detail:
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Created Date: 2012-8-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9602087 Medline TA: Heart Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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St Vincent's Hospital, Fitzroy, Victoria, Australia. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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