TY - JOUR
T1 - Changes in microvascular resistance following percutaneous coronary intervention - From the ILIAS global registry
AU - Eftekhari, Ashkan
AU - van de Hoef, Tim P.
AU - Hoshino, Masahiro
AU - Lee, Joo Myung
AU - Boerhout, Coen K. M.
AU - de Waard, Guus A.
AU - Jung, Ji-Hyun
AU - Lee, Seung Hun
AU - Mejia-Renteria, Hernan
AU - Echavarria-Pinto, Mauro
AU - Meuwissen, Martijn
AU - Matsuo, Hitoshi
AU - Madera-Cambero, Maribel
AU - Effat, Mohamed A.
AU - Marques, Koen
AU - Doh, Joon-Hyung
AU - Banerjee, Rupak
AU - Nam, Chang-Wook
AU - Niccoli, Giampaolo
AU - Murai, Tadashi
AU - Nakayama, Masafumi
AU - Tanaka, Nobuhiro
AU - Shin, Eun-Seok
AU - Knaapen, Paul
AU - van Royen, Niels
AU - Escaned, Javier
AU - Koo, Bon Kwon
AU - Chamuleau, Steven A. J.
AU - Kakuta, Tsunekazu
AU - Piek, Jan J.
AU - Christiansen, Evald H. j
N1 - Publisher Copyright: © 2023 The Author(s)
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Background: Microvascular resistance (MR) has prognostic value in acute and chronic coronary syndromes following percutaneous coronary intervention (PCI), however anatomic and physiologic determinants of the relative changes of MR and its association to target vessel failure (TVF) has not been investigated previously. This study aims to evaluate the association between changes in MR and TVF. Methods: This is a sub-study of the Inclusive Invasive Physiological Assessment in Angina Syndromes (ILIAS) registry which is a global multi-centre initiative pooling lesion-level coronary pressure and flow data. Results: Paired pre-post PCI haemodynamic data were available in n = 295 vessels out of n = 828 PCI treated patients and of these paired data on MR was present in n = 155 vessels. Vessels were divided according to increase vs. decrease % in microvascular resistance following PCI (ΔMR % ≤ 0 vs. ΔMR > 0%). Decreased microvascular resistance ΔMR % ≤ 0 occurred in vessels with lower pre-PCI fractional flow reserve (0.67 ± 0.15 vs. 0.72 ± 0.09 p = 0.051), coronary flow reserve (1.9 ± 0.8 vs. 2.6 ± 1.8 p < 0.0001) and higher hyperemic microvascular resistance (2.76 ± 1.3 vs. 1.62 ± 0.74 p = 0.001) and index of microvascular resistance (24.4 IQ (13.8) vs. 15. 8 IQ (13.2) p = 0.004). There was no difference in angiographic parameters between ΔMR % ≤ 0 vs. ΔMR > 0%. In a cox regression model ΔMR % > 0 was associated with increased rate of TVF (hazard ratio 95% CI 3.6 [1.2; 10.3] p = 0.018). Conclusion: Increased MR post-PCI was associated with lesions of less severe hemodynamic influence at baseline and higher rates of TVF at follow-up.
AB - Background: Microvascular resistance (MR) has prognostic value in acute and chronic coronary syndromes following percutaneous coronary intervention (PCI), however anatomic and physiologic determinants of the relative changes of MR and its association to target vessel failure (TVF) has not been investigated previously. This study aims to evaluate the association between changes in MR and TVF. Methods: This is a sub-study of the Inclusive Invasive Physiological Assessment in Angina Syndromes (ILIAS) registry which is a global multi-centre initiative pooling lesion-level coronary pressure and flow data. Results: Paired pre-post PCI haemodynamic data were available in n = 295 vessels out of n = 828 PCI treated patients and of these paired data on MR was present in n = 155 vessels. Vessels were divided according to increase vs. decrease % in microvascular resistance following PCI (ΔMR % ≤ 0 vs. ΔMR > 0%). Decreased microvascular resistance ΔMR % ≤ 0 occurred in vessels with lower pre-PCI fractional flow reserve (0.67 ± 0.15 vs. 0.72 ± 0.09 p = 0.051), coronary flow reserve (1.9 ± 0.8 vs. 2.6 ± 1.8 p < 0.0001) and higher hyperemic microvascular resistance (2.76 ± 1.3 vs. 1.62 ± 0.74 p = 0.001) and index of microvascular resistance (24.4 IQ (13.8) vs. 15. 8 IQ (13.2) p = 0.004). There was no difference in angiographic parameters between ΔMR % ≤ 0 vs. ΔMR > 0%. In a cox regression model ΔMR % > 0 was associated with increased rate of TVF (hazard ratio 95% CI 3.6 [1.2; 10.3] p = 0.018). Conclusion: Increased MR post-PCI was associated with lesions of less severe hemodynamic influence at baseline and higher rates of TVF at follow-up.
KW - Coronary flow reserve
KW - Fractional flow reserve
KW - Microvascular resistance
KW - Percutaneous coronary intervention
UR - http://www.scopus.com/inward/record.url?scp=85169512818&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ijcard.2023.131296
DO - https://doi.org/10.1016/j.ijcard.2023.131296
M3 - Article
C2 - 37633364
SN - 0167-5273
VL - 392
JO - International journal of cardiology
JF - International journal of cardiology
M1 - 131296
ER -