Abstract 11792: Predictors of Myocardial Damage Assessed by an Increase in the Index of Microcirculatory Resistance During Elective Percutaneous Coronary Intervention
Background: Distal coronary microembolization during percutaneous coronary intervention (PCI) leads to myocardial damage, and may limit patient prognosis. The purpose of this study is to identify factors predicting microcirculatory myocardial damage by assessing the index of microcirculatory resistance (IMR) between pre- and post- elective PCI.
Methods and Results: A total of 37 patients (29 males (78.3%), aged 70.6+/−6.9 years) with stable angina and planned PCI for single vessel disease (23 left anterior descending, 5 left circumflex, and 9 right coronary artery lesions) were enrolled in this study. IMR was serially measured at baseline (pre-IMR) and after the PCI (post-IMR) using PressureWire™ Certus (St. Jude Medical, MN). Plaque components (calcified, fibrous, or lipid) were also analyzed by using integrated backscatter intravascular ultrasound (IB-IVUS). Significant inverse correlation was observed between increase levels of IMR (ΔIMR) and serum high-density lipoprotein (HDL) cholesterol (r=−0.443, p=0.018). In addition, the low-density lipoprotein (LDL) cholesterol to HDL cholesterol ratio (LDL/HDL) was similarly correlated with ΔIMR (r=0.428, p=0.023). Post-IMR was solely associated with HDL (r=−0.470, p−0.015) and LDL/HDL (r=0.517, p=0.007). Multiple regression analysis with adjustment for covariates revealed that LDL/HDL ratio was exclusively associated with ΔIMR (r2=0.738, β=0.859, p=0.006). No other variables including plaque components were associated with ΔIMR.
Conclusion: High levels of preprocedural LDL/HDL ratio, and low levels of HDL can independently predict microcirculatory myocardial damage during elective PCI. Importance of serum lipid profiles should be highlighted to predict and to prevent periprocedural myocardial damage during elective PCI.
- © 2011 by American Heart Association, Inc.