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The Potential Use of the Index of Microcirculatory Resistance to Guide Stratification of Patients for Adjunctive Therapy in Acute Myocardial Infarction Interval From Initiation of Prasugrel to Coronary Angiography in Patients With Non–ST-Segment Elevation Myocardial Infarction Switching P2Y12-receptor inhibitors in patients with coronary artery disease Post-Discharge Bleeding and Mortality Following Acute Coronary Syndromes With or Without PCI Comparative Effectiveness of β-Blocker Use Beyond 3 Years After Myocardial Infarction and Long-Term Outcomes Among Elderly Patients Association between Coronary Collaterals and Myocardial Viability in Patients with a Chronic Total Occlusion Nonculprit Lesion Myocardial Infarction Following Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome Acute Coronary Syndrome Following Transcatheter Aortic Valve Replacement Chronic Kidney Disease and Coronary Artery Disease Cardiovascular Mortality After Type 1 and Type 2 Myocardial Infarction in Young Adults
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Review ArticleVolume 12, Issue 10, May 2019

JOURNAL：JACC Cardiovasc Interv. Article Link

The Potential Use of the Index of Microcirculatory Resistance to Guide Stratification of Patients for Adjunctive Therapy in Acute Myocardial Infarction

Maznyczka AM, Oldroyd KG, Berry C et al. Keywords: ST-segment elevation myocardial; adjunctive therapy; index of microcirculatory resistance; infarction; microvascular obstruction; stratified medicine

ABSTRACT

The goal of reperfusion therapies in ST-segment elevation myocardial infarction has evolved to include effective reperfusion of the microcirculation subtended by the culprit epicardial coronary artery. The index of microcirculatory resistance is measured using a pressure- and temperature-sensing coronary guidewire and quantifies microvascular dysfunction. The index of microcirculatory resistance is an independent predictor of microvascular obstruction, infarct size, and adverse clinical outcomes. It has the advantage of being immediately measurable in the catheterization laboratory, before the results of blood biomarkers or noninvasive imaging become available. This provides an opportunity for additional intervention that may alter outcomes. In this review, the authors provide a critical appraisal of the published research on the emerging role of the index of microcirculatory resistance as a tool to guide the stratification of patients for adjunctive therapeutic strategies in acute ST-segment elevation myocardial infarction.


Copyright © 2019. Published by Elsevier Inc.

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