Changes in microvascular resistance following percutaneous coronary intervention - From the ILIAS global registry
Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:392 |
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| Enthalten in: |
International journal of cardiology - 392(2023) vom: 01. Dez., Seite 131296 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Eftekhari, Ashkan [VerfasserIn] |
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| Links: |
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| Themen: |
Coronary flow reserve |
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| Anmerkungen: |
Date Completed 09.10.2023 Date Revised 08.11.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ijcard.2023.131296 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM361315309 |
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| 100 | 1 | |a Eftekhari, Ashkan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Changes in microvascular resistance following percutaneous coronary intervention - From the ILIAS global registry |
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| 500 | |a Date Completed 09.10.2023 | ||
| 500 | |a Date Revised 08.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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) | ||
| 520 | |a CONCLUSION: Increased MR post-PCI was associated with lesions of less severe hemodynamic influence at baseline and higher rates of TVF at follow-up | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Coronary flow reserve | |
| 650 | 4 | |a Fractional flow reserve | |
| 650 | 4 | |a Microvascular resistance | |
| 650 | 4 | |a Percutaneous coronary intervention | |
| 700 | 1 | |a van de Hoef, Tim P |e verfasserin |4 aut | |
| 700 | 1 | |a Hoshino, Masahiro |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Joo Myung |e verfasserin |4 aut | |
| 700 | 1 | |a Boerhout, Coen K M |e verfasserin |4 aut | |
| 700 | 1 | |a de Waard, Guus A |e verfasserin |4 aut | |
| 700 | 1 | |a Jung, Ji-Hyun |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Seung Hun |e verfasserin |4 aut | |
| 700 | 1 | |a Mejia-Renteria, Hernan |e verfasserin |4 aut | |
| 700 | 1 | |a Echavarria-Pinto, Mauro |e verfasserin |4 aut | |
| 700 | 1 | |a Meuwissen, Martijn |e verfasserin |4 aut | |
| 700 | 1 | |a Matsuo, Hitoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Madera-Cambero, Maribel |e verfasserin |4 aut | |
| 700 | 1 | |a Effat, Mohamed A |e verfasserin |4 aut | |
| 700 | 1 | |a Marques, Koen |e verfasserin |4 aut | |
| 700 | 1 | |a Doh, Joon-Hyung |e verfasserin |4 aut | |
| 700 | 1 | |a Banerjee, Rupak |e verfasserin |4 aut | |
| 700 | 1 | |a Nam, Chang-Wook |e verfasserin |4 aut | |
| 700 | 1 | |a Niccoli, Giampaolo |e verfasserin |4 aut | |
| 700 | 1 | |a Murai, Tadashi |e verfasserin |4 aut | |
| 700 | 1 | |a Nakayama, Masafumi |e verfasserin |4 aut | |
| 700 | 1 | |a Tanaka, Nobuhiro |e verfasserin |4 aut | |
| 700 | 1 | |a Shin, Eun-Seok |e verfasserin |4 aut | |
| 700 | 1 | |a Knaapen, Paul |e verfasserin |4 aut | |
| 700 | 1 | |a van Royen, Niels |e verfasserin |4 aut | |
| 700 | 1 | |a Escaned, Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Koo, Bon Kwon |e verfasserin |4 aut | |
| 700 | 1 | |a Chamuleau, Steven A J |e verfasserin |4 aut | |
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| 700 | 1 | |a Christiansen, Evald Høj |e verfasserin |4 aut | |
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