The Early Prediction For Perioperative Myocardial Injury In Patients With Stable Angina Pectoris And Acute Coronary Syndrome After Percutaneous Coronary Intervention(PCI) By Index Of Microcirculatory Resistance

Objective: Now the good indexes for predicting periprocedural myocardial injury(PMI)are cardiac damage markers and nuclear magnetic resonance imaging(MRI),which are too late to make an early therapy.IMR is a novel invasive technique that has been extensively validated in human.However,there is no data to date reported that the clinical value of IMR difference between pre-and post-PCI for early predicting PMI in patients with SAP and ACS after PCI.We aimed to determine the clinical significance of IMR for the early prediction for perioperative myocardial injury in patients with stable angina pectoris and acute coronary syndrome after PCI.Subjects and Methods: 164 patients who had single coronary lesion were consecutively enrolled.According to clinical manifestation,they were divided into SAP group(n=81)and ACS group(n=83).Basic clinical characteristics,angiographic results,procedural details,coronary physiological indexes and myocardial biomarkers were analyzed.Results: Mean transit time(Tmn),post-PCI IMR and ΔIMR of ACS group were more than those of SAP group after PCI(p<0.05).Plasma creatine kinase isoenzyme-MB difference and cardiac troponin-I(c TNI)difference between pre-and post PCI in ACS group were more than those in SAP group(p<0.05).The relationship of ΔIMR and Δc TNI was low(r=0.592),but the statistical significance was obvious(p<0.05).The area under The Receiver Operating Characteristic curve(AUC)of ΔIMR was0.763 to predict PMI(p<0.05),the optimum cut-off value of ΔIMR was 5.485 with70.0% sensitivity and 77.4% specificity.Conclusions: ΔIMR may be a good index for early predicting PMI after PCI,which was tend to take place in ACS patients as compared to SAP patients.It would guide us to make an early intensive therapy to prevent PMI.