The Role Of Index Of Mirocirculatory Resistance In Left Anterior Descending Artery St Segment Elevation Myocardial Infarction Patients With Thrombolysis In Myocardial Infarction Myocardial Perfusion Grade 3 After Primary Percutaneous Coronary Intervention

초록

Abstract The general consensus for Index of microcirculatory resistance (IMR) is that elevated IMR is associated with poor prognosis. Our aim was to assess the relationship of IMR in left anterior descending (LAD) artery involved ST segment elevation myocardial infarction (STEMI) patients with thrombolysis in myocardial infarction myocardial perfusion (TMP) grade 3 after successful primary percutaneous coronary intervention (PCI). Total of 116 LAD STEMI patients with TMP grade 3 after primary PCI were enrolled. The median value of IMR was 19.8U. Patients with IMR value higher than 19. 8U were categorized as group 1 and patients with IMR lower than 19.8U were categorized as group 2. Primary endpoint was all-cause mortality. Cardiac biomarkers such as peak creatinine kinase (CK), CK-myocardial band and Troponin-I levels were all higher for group 1 compared to group 2. Left ventricular (LV) ejection fraction was lower (43.83±6.16% vs 46.24±6.87%, p=0.049) for group 1 compared to group 2. For group 1 compared to group 2, all-cause mortality was higher (6.9% vs 0%, p=0.042) and Kaplan-Meier curve showed worse survival. Even for patients with TMP grade 3 after successful primary PCI, elevated IMR value represented larger infarct size, more severe LV dysfunction and higher mortality. Keywords: STEMI, TMP, IMR, all-cause mortality