Angio-Based Coronary Functional Assessment Predicts 30-Day New-Onset Heart Failure After Acute Myocardial Infarction

作者：Da Luo, Hui Wu, Wenjie Zhou, Jing Zhang, Xing Jin, Changwu Xu, Bing Huang, Jian Yang, Hong Jiang, Jing Chen · 发表于：ESC Heart Failure · 年份：2023 · DOI：10.1002/ehf2.14452 · 被引用次数：13 · 研究领域：Coronary Interventions and Diagnostics、Acute Myocardial Infarction Research、Cardiac Imaging and Diagnostics

Abstract Aims Suboptimal perfusion leading to heart failure (HF) often occurs after ST-segment elevation myocardial infarction (STEMI), despite restoration of epicardial coronary flow in primary percutaneous coronary intervention (PPCI) era. We determined the clinical implications of angio-based coronary functional assessment in evaluation of suboptimal perfusion and further outcomes among STEMI patients after successful PPCI. Methods and results In this study, STEMI patients in the Chinese STEMI PPCI registry trial (NCT04996901) who achieved post-PPCI thrombolysis in myocardial infarction grade 3 flow were retrospectively screened. Post-procedural quantitative flow ratio (QFR), angio-based microvascular resistance (AMR), and coronary flow velocity (CFV) of the infarct-related artery were calculated. QFR and AMR measure epicardial stenosis severity and microvascular resistance, respectively. QFR+ was defined as QFR < 0.90 while QFR− was QFR ≥ 0.90. AMR+ was defined as AMR ≥ 250 mmHg*s/m while AMR− was AMR < 250 mmHg*s/m. The primary outcome was 30-day new-onset HF. The Kaplan–Meier curves were used to establish the associations between QFR, AMR, CFV, and HF incidences. The relationship between CFV and combined QFR and AMR indices was further assessed. Independent predictors were determined using Cox regression analysis. The receiver-operating characteristic curve was used to assess discriminant ability to predict HF. A total of 942 patients (mean age was 57.8 ± ...