Angiography-versus wire-based microvascular resistance index to detect coronary microvascular obstruction associated with ST-segment elevation myocardial infarction

• Published in: International journal of cardiology 2024-09, Vol.411, p.132256, Article 132256
• Main Authors: Wang, Lin, Travieso, Alejandro, van der Hoeven, Nina, Lombardi, Marco, van Leeuwen, Maarten A.H., Janssens, Gladys, Shabbir, Asad, Mejía-Rentería, Hernán, Milasinovic, Dejan, Gonzalo, Nieves, Nijveldt, Robin, van Royen, Niels, Escaned, Javier
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; AngioIMR; IMR; Magnetic resonance imaging; Microvascular obstruction; Percutaneous coronary intervention
• ISSN: 0167-5273; 1874-1754; 1874-1754
• DOI: 10.1016/j.ijcard.2024.132256

Microvascular obstruction (MVO) measured by cardiac magnetic resonance (CMR) after ST-segment elevation myocardial infarction (STEMI) has important prognostic implications. While invasive index of microvascular resistance (IMR) have been shown to predict the occurrence and extent of MVO, the role of the angiography-based microvascular resistance (Angio-IMR) for this purpose remains unknown. The present study aims to perform a head-to-head comparison of wire-based and angiography-derived microcirculatory resistance (IMR and Angio-IMR, respectively) for the detection of MVO. Patients with a first STEMI and multivessel disease underwent CMR for detection of MVO, and angio-IMR and IMR measurements during PPCI and at 30 day follow up, both in STEMI culprit and non-culprit vessels. 58 patients were included (mean age 60.7 ± 9.9 years, 82% male). At the time of PPCI, angio-IMR and IMR exhibited significant correlation (r = 0.70, P