Incremental Value of Coronary Microcirculation Resistive Reserve Ratio in Predicting the Extent of Myocardial Infarction in Patients with STEMI. Insights from the Oxford Acute Myocardial Infarction (OxAMI) Study.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
Roberto ScarsiniAdrian P Banning

Abstract

Resistive reserve ratio (RRR) is a novel index that expresses the ratio between basal and hyperemic microcirculatory resistance. We sought to compare the performance of RRR, coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) in predicting the extent of infarct size (IS) after ST-elevation myocardial infarction. Thermodilution parameters were measured after primary percutaneous coronary intervention (PPCI) in 45 patients. In 30 (67%) cases pre-stenting measurements were also performed to assess the effect of PPCI on myocardial reperfusion, defined by CFR. Cardiovascular magnetic resonance (CMR) was performed at 48-h to assess area-at-risk (AAR), microvascular obstruction (MVO) and IS. CMR was repeated at 6 months in 39/45 patients. RRR (AUCRRR = 0.85, CI: 0.71-0.99) performed better compared to CFR (AUCCFR = 0.67, CI: 0.48-0.86) and IMR (AUCIMR = 0.70, CI: 0.52-0.88) in predicting IS% at 6-months. Patients with impaired RRR showed larger acute-IS% (27.4 [14.5-42.5] vs 15.4 [8.3-26], p = 0.018), MVO% (3.44 [0-5.97] vs 0 [0-0.89], p = 0.026), AAR% (43 [35-52] vs 34 [25-46], p = 0.03) and 6-months-IS% (22.7 [10.2-35] vs 8.8 [6.9-12.3], p = 0.006), higher rate of adverse remodeling (22.2% vs 0%, p = 0.04) and...Continue Reading

Citations

Jan 29, 2020·Journal of the American Heart Association·Annette M MaznyczkaColin Berry
May 16, 2020·Circulation. Cardiovascular Interventions·Annette M MaznyczkaColin Berry
Jun 25, 2020·Interventional Cardiology·Roberto ScarsiniAdrian Banning
Jul 7, 2020·Disease Markers·Alexander E Berezin, Alexander A Berezin
Feb 25, 2021·Current Cardiology Reports·Daniel J DohertyColin Berry
Dec 20, 2019·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Roberto ScarsiniUNKNOWN Collaborators
May 30, 2021·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Roberto ScarsiniAdrian P Banning
May 18, 2021·Journal of the American Heart Association·Takumi ToyaAmir Lerman

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