Predictive value of microcirculatory resistance index based on single-position coronary angiography for clinical outcomes in patients with non-obstructive coronary arteries
ZHANG Zi-xin
ZHANG Zhe
CHENG Wei-meng
KANG Li-na
WEI Zhong-hai
Abstract：Objective To evaluate the predictive value of the angiographic microvascular resistance(AMR)derived from single-position coronary angiography for major adverse cardiovascular events(MACE)in patients with ischaemia with non-obstructive coronary arteries(INOCA)after discharge.Methods A total of 331 patients who underwent coronary angiography(CAG)due to angina at the Department of Cardiology,Nanjing Drum Tower Hospital,between June 2021 and January 2024,were prospectively enrolled.The AMR was calculated using the AngioPlus Core software(Shanghai Pulsatile Medical Technology Co.,Ltd.).The patients were categorized into the MACE group and the non-MACE group based on the occurrence of MACE during follow-up.Additionally,they were stratified into the high-AMR and low-AMR groups according to the median AMR.Cox regression analysis,Kaplan-Meier survival curves and restricted cubic splines(RCS)were used to investigate the predictive value of single-vessel AMR and equivalent AMR(AMReq)for the prognosis of INOCA patients.Results The follow-up duration was one year,during which 45 patients(13.6%)experienced MACE.Compared with the non-MACE group,the MACE group had a higher AMReq[101.00(94.00,110.00)mmHg·s·m-1 vs.96.00(88.25,107.00)mmHg·s·m-1,P=0.023].In the adjusted multivariable Cox proportional hazards model,AMReq was identified as an independent risk factor for MACE within one year after discharge in INOCA patients.The RCS analysis demonstrated a positive linear relationship between AMReq and the risk of MACE within one year(Pnonlinear=0.306).Based on the median AMReq(96 mmHg·s·m-1),Kaplan-Meier survival analysis indicated that patients with AMReq≥96 mmHg·s·m-1 had a worse prognosis(P=0.012).Conclusion As a surrogate indicator for global coronary microvascular resistance,AMReq had independent predictive value for clinical adverse events in INOCA patients.
Keywords：Microvascular resistance indexIschaemia with non-obstructive coronary arteriesMajor adverse cardiovascular eventsPrognosis
Publication Date：2025-12-20
Online Publishing Date：2026-01-04(First online date of this platform, not the publication date of the document)
Pages：8( 1094-1101 )