title: Microcirculatory significance of periprocedural myocardial necrosis after percutaneous coronary intervention assessed by the index of microcirculatory resistance.
abstract: This study sought to investigate the relationship between the index of microcirculatory resistance (IMR) and periprocedural myocardial necrosis in patients with unstable angina pectoris (UAP). Fifty-seven UAP patients undergoing elective percutaneous coronary intervention (PCI) of a single lesion were recruited. A pressure-temperature sensor wire was used to measure IMR immediately after PCI. Total creatine kinase-MB (CK-MB) and troponin I (TNI) were measured every 8 h after PCI until they began to decline. Of the 57 patients studied, 22 had periprocedural myocardial infarction (MI) according to TNI. Post-PCI IMR >31 U had 86% sensitivity and 91% specificity for predicting periprocedural MI. There are a strong positive correlation between IMR and peak TNI (r = 0.805, p = 0.001), and a moderate positive correlation between IMR and peak CK-MB (r = 0.608, p = 0.003). Periprocedural myocardial injury, even in small area, during reperfusion is associated with impaired microcirculatory integrity as evaluated by IMR. Post-PCI IMR is independent predictive of developing periprocedural MI in patients with UAP, and, therefore, potentially enables a triage of higher risk patients to more intensive therapy.
authors.affiliation: Department of Cardiology, Nanjing First Hospital Affiliated to Nanjing Medical University, No. 68, Changle Street, Nanjing City, People's Republic of China, wuzhiming1997@126.com.
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Wu
authors.forename: Fei
authors.initials: F
authors.lastname: Ye
authors.forename: Wei
authors.initials: W
authors.lastname: You
authors.forename: Junjie
authors.initials: J
authors.lastname: Zhang
authors.forename: Dujiang
authors.initials: D
authors.lastname: Xie
authors.forename: Shaoliang
authors.initials: S
authors.lastname: Chen
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D002681:China; D003326:Coronary Circulation; D052279:Creatine Kinase, MB Form / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology*; D009336:Necrosis; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood; D014655:Vascular Resistance
chemical_list: D015415:Biomarkers; D019210:Troponin I; D052279:Creatine Kinase, MB Form