Measurement of microvascular function in patients presenting with thrombolysis for ST elevation myocardial infarction, and PCI for non-ST elevation myocardial infarction

Sonny Palmer, Jamie Layland, Heath Adams, Srikkumar Ashokkumar, Paul D. Williams, Christopher Judkins, Andre La Gerche, Andrew T. Burns, Robert J. Whitbourn, Andrew I. MacIsaac, Andrew M. Wilson

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: In this prospective study, we compared the invasive measures of microvascular function in two subsets: patients with pharmacoinvasive thrombolysis for STEMI, and patients undergoing percutaneous coronary intervention (PCI) for NSTEMI. Methods: The study consisted of 17 patients with STEMI referred for cardiac catheterisation post thrombolysis, and 20 patients with NSTEMI. Coronary physiological indexes were measured in each patient before and after PCI. Results: The median pre-PCI index of microcirculatory function (IMR) at baseline was significantly higher in the STEMI group than the NSTEMI group (26 units vs. 15 units, p = 0.02). Following PCI, IMR decreased in both groups (STEMI 20 units vs. NSTEMI 14 units, p = 0.10). There was an inverse correlation between post PCI IMR and left ventricular ejection fraction (LVEF) (r = −0.52, p = 0.001). Furthermore, post PCI IMR was an independent predictor of index admission LVEF in the total population (β = −0.388, p = 0.02). Conclusion: Invasive measures of microvascular function are inferior in a pharmacoinvasive STEMI group compared to a clinically stable NSTEMI group. In the STEMI population, the IMR following coronary intervention appears to predict LVEF.

Original languageEnglish
Pages (from-to)917-922
Number of pages6
JournalCardiovascular Revascularization Medicine
Volume19
Issue number8
DOIs
Publication statusPublished - Dec 2018
Externally publishedYes

Keywords

  • Acute coronary syndrome
  • Index of microcirculatory resistance
  • Microcirculation
  • Percutaneous coronary intervention
  • Thrombolysis

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