The potential use of the index of microcirculatory resistance to guide stratification of patients for adjunctive therapy in acute myocardial infarction

Maznyczka, A. M., Oldroyd, K. G., McCartney, P., McEntegart, M. and Berry, C. (2019) The potential use of the index of microcirculatory resistance to guide stratification of patients for adjunctive therapy in acute myocardial infarction. JACC: Cardiovascular Interventions, 12(10), pp. 951-966. (doi: 10.1016/j.jcin.2019.01.246) (PMID:31122353)

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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.

Item Type:Articles
Keywords:ST-segment elevation myocardial, adjunctive therapy, index of microcirculatory resistance, infarction, microvascular obstruction, stratified medicine.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McEntegart, Dr Margaret and McCartney, Dr Peter and Oldroyd, Dr Keith and Berry, Professor Colin and Maznyczka, Dr Annette Marie
Authors: Maznyczka, A. M., Oldroyd, K. G., McCartney, P., McEntegart, M., and Berry, C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:JACC: Cardiovascular Interventions
Publisher:Elsevier
ISSN:1936-8798
ISSN (Online):1876-7605
Published Online:20 May 2019

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
174049T-TIME Coronary Physiology StudyColin BerryBritish Heart Foundation (BHF)FS/16/74/32573Institute of Cardiovascular & Medical Sciences
190814BHF centre of excellenceRhian TouyzBritish Heart Foundation (BHF)RE/13/5/30177Institute of Cardiovascular & Medical Sciences
303944BHF Centre of ExcellenceRhian TouyzBritish Heart Foundation (BHF)RE/18/6/34217CAMS - Cardiovascular Science