The Relationship between Coronary Resting Full-cycle Ratio before PCI and Long-term Prognosis in Patients with Acute Myocardial Infarction

QI Shanliang; JIANG Lina

doi:10.12102/j.issn.1672-1349.2025.02.017

Abstract：Objective: To analyze the relationship between pre-procedural coronary resting full-cycle ratio (RFR) and long-term prognosis in patients with acute myocardial infarction (AMI). Methods: A prospective cohort study was conducted, selecting 147 AMI patients who were scheduled for percutaneous coronary intervention (PCI) surgery at our hospital from January 2019 to January 2020. All patients had their RFR measured before the procedure, and were divided into a high RFR group (65 cases) and a low RFR group (82 cases) based on the median RFR value of 0.89. After PCI, patients were followed up for 2 years to evaluate their long-term prognosis, and the relationship between pre-procedural RFR and long-term prognosis in AMI patients was analyzed. Results: The levels of troponin T (cTnT) and creatine kinase isoenzyme (CK-MB) at pre-procedure and discharge were higher in the low RFR group compared to the high RFR group. The pre-procedure and discharge values of standard deviation of all normal sinus intervals (SDNN), percentage of heartbeats with differences greater than 50 ms between adjacent sinus intervals (PNN50), and standard deviation of average normal sinus interval over 5 minutes within 24 hours (SDANN) were lower in the low RFR group, with statistically significant differences (P < 0.05). The incidence of adverse long-term prognosis was higher in the low RFR group compared to the high RFR group, with a statistically significant difference (χ² = 5.504, P = 0.019). In the adverse long-term prognosis group, Killip functional class and pre-procedure CK-MB levels were higher, while pre-procedure SDNN, PNN50, and RFR were lower compared to the favorable long-term prognosis group, with statistically significant differences (P < 0.05). Point-biserial correlation analysis showed that pre-procedural RFR in AMI patients was negatively correlated with long-term prognosis (r = -0.344, P < 0.001). Pre-procedural RFR had good predictive value for long-term prognosis in AMI patients. Conclusion: A low pre-procedural RFR in AMI patients may reduce the effectiveness of PCI treatment and increase the risk of adverse long-term prognosis, and pre-procedural RFR has good predictive value for adverse long-term prognosis in AMI patients.