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急性冠脉综合征

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Early invasive versus non-invasive treatment in patients with non-ST-elevation acute coronary syndrome (FRISC-II): 15 year follow-up of a prospective, randomised, multicentre study Managing Multivessel Coronary Artery Disease in Patients With ST-Elevation Myocardial Infarction: A Comprehensive Review Canadian spontaneous coronary artery dissection cohort study: in-hospital and 30-day outcomes Diagnosis and Prognosis of Coronary Artery Disease with SPECT and PET The prognostic role of mid-range ejection fraction in ST-segment elevation myocardial infarction Risk of Myocardial Infarction in Anticoagulated Patients With Atrial Fibrillation Acute Noncardiac Organ Failure in Acute Myocardial Infarction With Cardiogenic Shock 1-Year Outcomes of Patients Undergoing Primary Angioplasty for Myocardial Infarction Treated With Prasugrel Versus Ticagrelor Off-hour presentation and outcomes in patients with acute myocardial infarction: systematic review and meta-analysis A Novel Circulating MicroRNA for the Detection of Acute Myocarditis

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.