Correlation between myocardial microcirculation characteristics and coronary artery high thrombotic load in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary in-tervention

Shi Jianyou; He Yan

doi:10.3969/j.issn.1674-4055.2024.11.23

Abstract：Objective To investigate the correlation between myocardial microcirculation characteristics and coronary artery high thrombotic load in patients with acute ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods STEMI patients undergone PCI(n=183)were chosen from Affiliated Hospital of Guizhou Medical University from Jan.2020 to Jan.2022,and divided,according to thrombotic load status,into high-thrombotic load group(n=60)and low-thrombotic load group(n=123).The general materials and indexes of myocardial microcirculation characteristics were compared between 2 groups before and after PCI.The influence of interaction of coronary flow reserve(CFR)and index of microcirculatory resistance(IMR)on coronary artery thrombotic load was analyzed by using factorial design analysis of variance.The predictive value of CFR and IMR to coronary artery high thrombotic load was reviewed by using ROC curve analysis in STEMI patients.STEMI patients were divided,according to SYNTAX scores,into high-score subgroup(scores ≥ 33,n=75)and low-score subgroup(scores＜33,n=108),and clinical materials were compared between 2 subgroups.A correction model was established by using Logistic regression analysis.The relationship between indexes of myocardial microcirculation characteristics and coronary artery high thrombotic load in high-score subgroup was analyzed.The influence of CFR,IMR and SYNTAX scores on coronary artery high thrombotic load was analyzed by using Cox proportional hazard regression model.Results The results of factorial design analysis of variance showed that there was interaction between CFR and IMR,and predictive efficacy of CFR and IMR to coronary artery high thrombotic load was high in STEMI patients,and predictive efficacy of CFR combined with IMR was higher.The results of Logistic regression analysis showed that,after correcting confounding factors,CFR and IMR were independent risk factors of coronary artery high thrombotic load(OR=0.806,OR=1.980)in high-score subgroup(P＜0.05).The results of interaction analysis showed that there was a multiplicative interaction among CFR,IMR and SYNTAX scores.Conclusion CFR and IMR are influence factors of coronary artery high thrombotic load,and they have additive and multiplicative interaction to influence on coronary artery high thrombotic load in STEMI patients after PCI.