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Clinical and Angiographic Predictors of Microvascular Dysfunction in ST-Segment Elevation Myocardial Infarction.

Baek YS, Park SD, Kim SH, Lee MJ, Shin SH, Kim DH, Kwan J, Park KS, Woo SI - Yonsei Med. J. (2015)

Bottom Line: The age of the Low IMR group was significantly lower than that of the Mid and High IMR groups.Meanwhile, the symptom-onset-to-balloon time was significantly longer in the High IMR group, compared to the Mid and Low IMR groups (p<0.001).In the high IMR group, the culprit lesion was found in a proximal location significantly more often than in a non-proximal location (p=0.008).

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Inha University Hospital, Incheon, Korea.

ABSTRACT

Purpose: We aimed to discover clinical and angiographic predictors of microvascular dysfunction using the index of microcirculatory resistance (IMR) in patients with ST-segment elevation myocardial infarction (STEMI).

Materials and methods: We enrolled 113 patients with STEMI (age, 56±11 years; 95 men) who underwent primary percutaneous coronary intervention (PCI). The IMR was measured with a pressure sensor/thermistor-tipped guidewire after primary PCI. The patients were divided into three groups based on IMR values: Low IMR [<18 U (12.9±2.6 U), n=38], Mid IMR [18-31 U (23.9±4.0 U), n=38], and High IMR [>31 U (48.1±17.1 U), n=37].

Results: The age of the Low IMR group was significantly lower than that of the Mid and High IMR groups. The door-to-balloon time was <90 minutes in all patients, and it was not significantly different between groups. Meanwhile, the symptom-onset-to-balloon time was significantly longer in the High IMR group, compared to the Mid and Low IMR groups (p<0.001). In the high IMR group, the culprit lesion was found in a proximal location significantly more often than in a non-proximal location (p=0.008). In multivariate regression analysis, age and symptom-onset-to-balloon time were independent determinants of a high IMR (p=0.013 and p=0.003, respectively).

Conclusion: Our data suggest that age and symptom-onset-to-balloon time might be the major predictors of microvascular dysfunction in STEMI patients with a door-to-balloon time of <90 minutes.

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Related in: MedlinePlus

Relations of age (A), CK peak (B), and symptom-onset-to-balloon time (C) to increasing IMR. Solid lines represent linear regression lines. IMR, index of microcirculatory resistance; CK, creatine kinase.
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Figure 1: Relations of age (A), CK peak (B), and symptom-onset-to-balloon time (C) to increasing IMR. Solid lines represent linear regression lines. IMR, index of microcirculatory resistance; CK, creatine kinase.

Mentions: In correlation analysis, significant association was found between IMR values and age (r=0.219, p=0.020), CK level (r=0.342, p=0.010), and the symptom-onset-to-balloon time (r=0.463, p<0.001) (Fig. 1).


Clinical and Angiographic Predictors of Microvascular Dysfunction in ST-Segment Elevation Myocardial Infarction.

Baek YS, Park SD, Kim SH, Lee MJ, Shin SH, Kim DH, Kwan J, Park KS, Woo SI - Yonsei Med. J. (2015)

Relations of age (A), CK peak (B), and symptom-onset-to-balloon time (C) to increasing IMR. Solid lines represent linear regression lines. IMR, index of microcirculatory resistance; CK, creatine kinase.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4541652&req=5

Figure 1: Relations of age (A), CK peak (B), and symptom-onset-to-balloon time (C) to increasing IMR. Solid lines represent linear regression lines. IMR, index of microcirculatory resistance; CK, creatine kinase.
Mentions: In correlation analysis, significant association was found between IMR values and age (r=0.219, p=0.020), CK level (r=0.342, p=0.010), and the symptom-onset-to-balloon time (r=0.463, p<0.001) (Fig. 1).

Bottom Line: The age of the Low IMR group was significantly lower than that of the Mid and High IMR groups.Meanwhile, the symptom-onset-to-balloon time was significantly longer in the High IMR group, compared to the Mid and Low IMR groups (p<0.001).In the high IMR group, the culprit lesion was found in a proximal location significantly more often than in a non-proximal location (p=0.008).

View Article: PubMed Central - PubMed

Affiliation: Division of Cardiology, Inha University Hospital, Incheon, Korea.

ABSTRACT

Purpose: We aimed to discover clinical and angiographic predictors of microvascular dysfunction using the index of microcirculatory resistance (IMR) in patients with ST-segment elevation myocardial infarction (STEMI).

Materials and methods: We enrolled 113 patients with STEMI (age, 56±11 years; 95 men) who underwent primary percutaneous coronary intervention (PCI). The IMR was measured with a pressure sensor/thermistor-tipped guidewire after primary PCI. The patients were divided into three groups based on IMR values: Low IMR [<18 U (12.9±2.6 U), n=38], Mid IMR [18-31 U (23.9±4.0 U), n=38], and High IMR [>31 U (48.1±17.1 U), n=37].

Results: The age of the Low IMR group was significantly lower than that of the Mid and High IMR groups. The door-to-balloon time was <90 minutes in all patients, and it was not significantly different between groups. Meanwhile, the symptom-onset-to-balloon time was significantly longer in the High IMR group, compared to the Mid and Low IMR groups (p<0.001). In the high IMR group, the culprit lesion was found in a proximal location significantly more often than in a non-proximal location (p=0.008). In multivariate regression analysis, age and symptom-onset-to-balloon time were independent determinants of a high IMR (p=0.013 and p=0.003, respectively).

Conclusion: Our data suggest that age and symptom-onset-to-balloon time might be the major predictors of microvascular dysfunction in STEMI patients with a door-to-balloon time of <90 minutes.

Show MeSH
Related in: MedlinePlus