Periprocedural Assessment of Coronary Microcirculatory Function Predicts Clinical Outcomes After Elective PCI

Strategic Insights -

Percutaneous coronary intervention (PCI) is a critical treatment for patients with stable coronary artery disease, and restoring epicardial blood flow through stent-based angioplasty can significantly improve clinical outcomes. However, the prognostic significance of periprocedural coronary microcirculatory function, which can be quantified by the angiography-derived index of microcirculatory resistance (angio-IMR), remains unclear. This study aimed to assess the association between angio-IMR before and after PCI and long-term prognosis in patients undergoing elective PCI.

Key Takeaways:

  • The study included 1768 patients with stable coronary artery disease undergoing elective PCI.
  • The primary end point was major adverse cardiac events (MACE) comprising death and nonfatal myocardial infarction.
  • The median angio-IMR was 11.3 (interquartile range, 7.7-15.0) and 17.0 (interquartile range, 14.1-20.4) before and after PCI (P < 0.001).
  • High periprocedural angio-IMR (≥12) was independently associated with an increased risk of MACE (adjusted hazard ratio, 2.43 [95% CI, 1.32-4.49]; P=0.004).
  • High angio-IMR was associated with an increased risk of MACE compared to periprocedural myocardial infarction (area under the curve, 0.681 versus 0.635, P=0.03).
  • The study concluded that angio-IMR was a predictor of MACE in patients with stable coronary artery disease undergoing elective PCI.
  • Incorporating angio-IMR could enhance the identification of patients at high risk of MACE.

Statistics:

  • 1768 patients with stable coronary artery disease underwent elective PCI.
  • The median angio-IMR was 11.3 (interquartile range, 7.7-15.0) and 17.0 (interquartile range, 14.1-20.4) before and after PCI.
  • High periprocedural angio-IMR (≥12) increased the risk of MACE by 143%.
  • High angio-IMR (10-12) increased the risk of MACE by 43% compared to low angio-IMR (<10).
  • The area under the curve for predicting MACE using high angio-IMR was 0.681, while using periprocedural myocardial infarction was 0.635.

Sources:

  • NewsRx. Researchers from Fudan University Describe Findings in Cardiovascular and Cerebrovascular Diseases (Periprocedural Assessment of Coronary Microcirculatory Function to Predict Clinical Outcomes After Elective Percutaneous Coronary Intervention). Cardiovascular Week. October 20, 2025; p 145.
  • Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease. Periprocedural Assessment of Coronary Microcirculatory Function to Predict Clinical Outcomes After Elective Percutaneous Coronary Intervention. 2025,14(19). (http://jaha.ahajournals.org).