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Prognostic significance of severe coronary microvascular dysfunction post-PCI in patients with STEMI: A systematic review and meta-analysis
Coronary microvascular dysfunction (CMVD) is common and associated with poorer outcomes in patients with ST Segment Elevation Myocardial Infarction (STEMI). The index of microcirculatory resistance (IMR) and the index of hyperemic microvascular resistance (HMR) are both invasive indexes of microvasc...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9109915/ https://www.ncbi.nlm.nih.gov/pubmed/35576227 http://dx.doi.org/10.1371/journal.pone.0268330 |
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author | Canu, Marjorie Khouri, Charles Marliere, Stéphanie Vautrin, Estelle Piliero, Nicolas Ormezzano, Olivier Bertrand, Bernard Bouvaist, Hélène Riou, Laurent Djaileb, Loic Charlon, Clémence Vanzetto, Gerald Roustit, Matthieu Barone-Rochette, Gilles |
author_facet | Canu, Marjorie Khouri, Charles Marliere, Stéphanie Vautrin, Estelle Piliero, Nicolas Ormezzano, Olivier Bertrand, Bernard Bouvaist, Hélène Riou, Laurent Djaileb, Loic Charlon, Clémence Vanzetto, Gerald Roustit, Matthieu Barone-Rochette, Gilles |
author_sort | Canu, Marjorie |
collection | PubMed |
description | Coronary microvascular dysfunction (CMVD) is common and associated with poorer outcomes in patients with ST Segment Elevation Myocardial Infarction (STEMI). The index of microcirculatory resistance (IMR) and the index of hyperemic microvascular resistance (HMR) are both invasive indexes of microvascular resistance proposed for the diagnosis of severe CMVD after primary percutaneous coronary intervention (pPCI). However, these indexes are not routinely assessed in STEMI patients. Our main objective was to clarify the association between IMR or HMR and long-term major adverse cardiovascular events (MACE), through a systematic review and meta-analysis of observational studies. We searched Medline, PubMed, and Google Scholar for studies published in English until December 2020. The primary outcome was a composite of cardiovascular death, non-cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and rehospitalization for heart failure occurring after at least 6 months following CMVD assessment. We identified 6 studies, reporting outcomes in 1094 patients (mean age 59.7 ± 11.4 years; 18.2% of patients were women) followed-up from 6 months to 7 years. Severe CMVD, defined as IMR > 40 mmHg or HMR > 3mmHg/cm/sec was associated with MACE with a pooled HR of 3.42 [2.45; 4.79]. Severe CMVD is associated with an increased risk of long-term adverse cardiovascular events in patients with STEMI. Our results suggest that IMR and HMR are useful for the early identification of severe CMVD in patients with STEMI after PCI, and represent powerful prognostic assessments as well as new therapeutic targets for clinical intervention. |
format | Online Article Text |
id | pubmed-9109915 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-91099152022-05-17 Prognostic significance of severe coronary microvascular dysfunction post-PCI in patients with STEMI: A systematic review and meta-analysis Canu, Marjorie Khouri, Charles Marliere, Stéphanie Vautrin, Estelle Piliero, Nicolas Ormezzano, Olivier Bertrand, Bernard Bouvaist, Hélène Riou, Laurent Djaileb, Loic Charlon, Clémence Vanzetto, Gerald Roustit, Matthieu Barone-Rochette, Gilles PLoS One Research Article Coronary microvascular dysfunction (CMVD) is common and associated with poorer outcomes in patients with ST Segment Elevation Myocardial Infarction (STEMI). The index of microcirculatory resistance (IMR) and the index of hyperemic microvascular resistance (HMR) are both invasive indexes of microvascular resistance proposed for the diagnosis of severe CMVD after primary percutaneous coronary intervention (pPCI). However, these indexes are not routinely assessed in STEMI patients. Our main objective was to clarify the association between IMR or HMR and long-term major adverse cardiovascular events (MACE), through a systematic review and meta-analysis of observational studies. We searched Medline, PubMed, and Google Scholar for studies published in English until December 2020. The primary outcome was a composite of cardiovascular death, non-cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and rehospitalization for heart failure occurring after at least 6 months following CMVD assessment. We identified 6 studies, reporting outcomes in 1094 patients (mean age 59.7 ± 11.4 years; 18.2% of patients were women) followed-up from 6 months to 7 years. Severe CMVD, defined as IMR > 40 mmHg or HMR > 3mmHg/cm/sec was associated with MACE with a pooled HR of 3.42 [2.45; 4.79]. Severe CMVD is associated with an increased risk of long-term adverse cardiovascular events in patients with STEMI. Our results suggest that IMR and HMR are useful for the early identification of severe CMVD in patients with STEMI after PCI, and represent powerful prognostic assessments as well as new therapeutic targets for clinical intervention. Public Library of Science 2022-05-16 /pmc/articles/PMC9109915/ /pubmed/35576227 http://dx.doi.org/10.1371/journal.pone.0268330 Text en © 2022 Canu et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Canu, Marjorie Khouri, Charles Marliere, Stéphanie Vautrin, Estelle Piliero, Nicolas Ormezzano, Olivier Bertrand, Bernard Bouvaist, Hélène Riou, Laurent Djaileb, Loic Charlon, Clémence Vanzetto, Gerald Roustit, Matthieu Barone-Rochette, Gilles Prognostic significance of severe coronary microvascular dysfunction post-PCI in patients with STEMI: A systematic review and meta-analysis |
title | Prognostic significance of severe coronary microvascular dysfunction post-PCI in patients with STEMI: A systematic review and meta-analysis |
title_full | Prognostic significance of severe coronary microvascular dysfunction post-PCI in patients with STEMI: A systematic review and meta-analysis |
title_fullStr | Prognostic significance of severe coronary microvascular dysfunction post-PCI in patients with STEMI: A systematic review and meta-analysis |
title_full_unstemmed | Prognostic significance of severe coronary microvascular dysfunction post-PCI in patients with STEMI: A systematic review and meta-analysis |
title_short | Prognostic significance of severe coronary microvascular dysfunction post-PCI in patients with STEMI: A systematic review and meta-analysis |
title_sort | prognostic significance of severe coronary microvascular dysfunction post-pci in patients with stemi: a systematic review and meta-analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9109915/ https://www.ncbi.nlm.nih.gov/pubmed/35576227 http://dx.doi.org/10.1371/journal.pone.0268330 |
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