BACKGROUND: Coronary microvascular dysfunction has been associated with adverse cardiovascular events following acute myocardial infarction. This study evaluates the role of the angiography-derived index of microcirculatory resistance (angio-IMR) in predicting myocardial damage in patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI). METHODS AND RESULTS: In this post hoc analysis of the CLEVER-ACS (Controlled-Level Everolimus in Acute Coronary Syndromes) trial, the associations between post-PCI angio-IMR of infarct-related coronary arteries (IRAs) and infarct size, microvascular obstruction, and left ventricular ejection fraction at 30 days as assessed by cardiac magnetic resonance were investigated. High post-PCI angio-IMR was defined as ≥40 mm Hg*s . In non-IRAs, angio-IMR was measured before IRA-PCI. A total of 52 IRAs and 94 non-IRAs of 52 patients were analyzed. Post-PCI angio-IMR was 41.5 (interquartile range [IQR], 28.5-55.7) mm Hg*s in IRAs and pre-PCI angio-IMR was 43.7 (IQR, 31.7-54.0) mm Hg*s in non-IRAs ( CONCLUSIONS: In patients with ST-segment-elevation myocardial infarction, post-PCI angio-IMR was identified as independent predictor of myocardial infarct size and extent of microvascular obstruction. REGISTRATION: URL: https://clinicaltrials.gov
Unique Identifier: NCT01529554.