Relationship between Coronary Angiography Derived Angio-index of Microcirculatory Resistance and Prognosis of Patients with Unstable Angina Pectoris after PCI

AN Jie; CHEN Xinyi; ZHAO Guoli; YAO Yueming; LI Qunxing; YIN Delu

doi:10.12102/j.issn.1672-1349.2025.13.011

Abstract：Objective: To explore the relationship between the coronary angiography-derived microcirculatory resistance index (AMR) and the prognosis of patients with unstable angina pectoris (UAP) after percutaneous coronary intervention (PCI). Methods: A total of 200 UAP patients who underwent PCI at the First People's Hospital of Lianyungang City from January 2020 to December 2021 were selected as the study subjects. After discharge following PCI, all patients received a 6-month follow-up, and the occurrence of major adverse cardiovascular events (MACE) during the follow-up period was used as the prognosis standard. Patients were divided into groups with poor prognosis and good prognosis based on MACE occurrence. Clinical data, blood-related indicators, and AMR values were compared between the two groups. Logistic regression analysis was used to identify factors affecting the prognosis of UAP patients. Receiver operating characteristic (ROC) curves were drawn to analyze the predictive value of AMR for the prognosis of UAP patients. Results: Among the 197 UAP patients who underwent PCI, 32 experienced MACE, with an incidence rate of 16.24% (32/197). The serum C-reactive protein (CRP), total cholesterol (TC) levels, and AMR values were higher in the poor prognosis group compared to the good prognosis group, with statistically significant differences (P < 0.05). Bivariate correlation analysis showed that serum CRP, TC levels, and AMR values were positively correlated with poor prognosis in UAP patients (P < 0.05). Multivariate logistic regression analysis showed that high expression of serum CRP and TC, and high AMR values were associated with poor prognosis after PCI in UAP patients (P < 0.05). ROC curve analysis showed that the area under the curve (AUC) values for predicting poor prognosis after PCI in UAP patients by serum CRP, TC levels, and AMR values alone or in combination were 0.702, 0.643, 0.802, and 0.853, respectively, with the combined assessment showing the highest value. There was no statistically significant difference between the AUC values of AMR alone and the combined assessment (Z = 0.793, P = 0.428). Conclusion: The coronary angiography-derived AMR value is closely related to the prognosis of UAP patients after PCI and has certain predictive value for patient prognosis, potentially serving as an auxiliary indicator for clinical prognosis assessment.