Combined risk estimates of diabetes and coronary angiography-derived index of microcirculatory resistance in patients with non-ST elevation myocardial infarction

• Published in: Cardiovascular diabetology Vol. 23; no. 1; pp. 300 - 11
• Main Authors: Chen, Delong, Zhang, Yuxuan, Yidilisi, Abuduwufuer, Hu, Die, Zheng, Yiyue, Fang, Jiacheng, Gong, Qinyan, Huang, Jiniu, Dong, Qichao, Pu, Jun, Niu, Tiesheng, Xiang, Jianping, Wang, Jian'an, Jiang, Jun
• Format: Journal Article
• Language: English
• Published: England BioMed Central 16-08-2024; BMC
• Subjects: Aged; Angiography; Angiography-derived index of microcirculatory resistance; Cardiovascular disease; China - epidemiology; Chronic illnesses; Clinical outcomes; Congestive heart failure; Coronary Angiography; Coronary artery disease; Coronary Circulation; Coronary microvascular dysfunction; Coronary vessels; Death; Diabetes; Diabetes mellitus; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Fatalities; Female; Health risk assessment; Heart attacks; Heart Failure - diagnosis; Heart Failure - diagnostic imaging; Heart Failure - epidemiology; Heart Failure - mortality; Heart Failure - physiopathology; Heart Failure - therapy; Hospitals; Humans; Hypertension; Male; Medical imaging; Medical records; Microcirculation; Microvasculature; Middle Aged; Mortality; Myocardial infarction; Non-ST Elevated Myocardial Infarction - diagnostic imaging; Non-ST Elevated Myocardial Infarction - mortality; Non-ST Elevated Myocardial Infarction - physiopathology; Non-ST Elevated Myocardial Infarction - therapy; Non-ST-segment elevation myocardial infarction; Patient Readmission; Patients; Percutaneous Coronary Intervention - adverse effects; Predictive Value of Tests; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome; Vascular Resistance; China; Non-ST-segment elevation myocardial infarction; Coronary microvascular dysfunction; Diabetes mellitus; Angiography-derived index of microcirculatory resistance
• ISSN: 1475-2840; 1475-2840
• DOI: 10.1186/s12933-024-02400-1

Diabetes mellitus (DM) and coronary microvascular dysfunction (CMD) increase the risk of adverse cardiac events in patients with non-ST-segment elevation myocardial infarction (NSTEMI). This study aimed to evaluate the combined risk estimates of DM and CMD, assessed by the angiography-derived index of microcirculatory resistance (angio-IMR), in patients with NSTEMI.
A total of 2212 patients with NSTEMI who underwent successful percutaneous coronary intervention (PCI) were retrospectively enrolled from three centers. The primary outcome was a composite of cardiac death or readmission for heart failure at a 2-year follow-up.
Post-PCI angio-IMR did not significantly differ between the DM group and the non-DM group (20.13 [17.91-22.70] vs. 20.19 [18.14-22.77], P = 0.530). DM patients exhibited a notably higher risk of cardiac death or readmission for heart failure at 2 years compared to non-DM patients (9.5% vs. 5.4%, P < 0.001). NSTEMI patients with both DM and CMD experienced the highest cumulative incidence of cardiac death or readmission for heart failure at 2 years (24.0%, P < 0.001). The combination of DM and CMD in NSTEMI patients were identified as the most powerful independent predictor for cardiac death or readmission for heart failure at 2 years (adjusted HR: 7.894, [95% CI, 4.251-14.659], p < 0.001).
In patients with NSTEMI, the combination of DM and CMD is an independent predictor of cardiac death or readmission for heart failure. Angio-IMR could be used as an additional evaluation tool for the management of NSTEMI patients with DM.
URL: https://www.
gov ; Unique identifier: NCT05696379.