Correlation and significance of TMPFC and anxiety status with cardiac endpoint events after PCI for acute myocardial infarction

WANG Meng; LI Guodong; CHENG Cheng; HUANG Yifang; LI Yan; HU Shuzhen; LI Rongsen; BIAN Ning; QI Hairu

doi:10.3969/j.issn.1002-3429.2025.22.005

Abstract：Objective To study the correlation and significance of thrombolysis in myocardial perfusion frame count(TMPFC),anxiety status and early cardiac endpoint events after percutaneous coronary intervention(PCI)for acute myocardial infarction(AMI).Methods A prospective cohort study was conducted on 307 AMI patients admitted from February 2019 to June 2023 and undergoing PCI.They were divided into the occurrence group(n=31)and the non-occurrence group(n=276)based on occurrence of cardiac endpoint events at 3 months after PCI.TMPFC and Hamilton Anxiety Scale(HAMA)scores of the two groups were compared.Multivariate logistic regression was used to analyze the correlation between microvascular dysfunction(TMPFC＞95.5 frames),anxiety status and cardiac endpoint events in patients with AMI after PCI.The interaction coefficient γ and OR were used to analyze presence or absence of the interaction between microvascular dysfunction and anxiety status on cardiac endpoint events and the types of interaction in patients after PCI.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of TMPFC,HAMA score and their combination for early cardiac endpoint events in patients after PCI.Results The TMPFC and HAMA scores of the occurrence group were higher than those of the non-occurrence group(P＜0.01).Multivariate logistic regression analysis indicated that both cardiac microvascular dysfunction and anxiety status after PCI were associated with cardiac endpoint events in AMI patients after PCI(P＜0.05).Interaction analysis showed that the interaction effect of anxiety status and microvascular dysfunction on cardiac endpoint events in AMI patients after PCI satisfied the submultiplicative model,and γ=1.306.The effect of anxiety status on microvascular dysfunction had a positive interaction(P＜0.05).The ROC curve showed that the area under the curve(AUC)of TMPFC and HAMA scores for predicting cardiac endpoint events was 0.756 and 0.775,respectively.The AUC of the two in combination for prediction was 0.939,which was greater than that of TMPFC and HAMA score detected alone(P＜0.05),with a sensitivity of 83.87％and a specificity of 89.86％.Conclusion Both TMPFC and anxiety status are associated with the occurrence of early cardiac endpoint events after PCI in AMI patients.When cardiac microvascular dysfunction coexists with anxiety status,their effect in combination exceeds the sum of their individual effects.The combination of TMPFC and HAMA scores can effectively predict cardiac endpoint events.