Combined risk estimates of diabetes and coronary angiography-derived index of microcirculatory resistance in patients with non-ST elevation myocardial infarction

• Published in: Cardiovascular diabetology Vol. 23; no. 1; pp. 1 - 11
• Main Authors: Delong, Chen, Zhang, Yuxuan, Yidilisi, Abuduwufuer, Hu, Die, Zheng, Yiyue, Fang, Jiacheng, Gong, Qinyan, Huang, Jiniu, Dong, Qichao, Pu, Jun, Niu, Tiesheng, Xiang, Jianping, Jian’an Wang, Jiang, Jun
• Format: Journal Article
• Language: English
• Published: London BioMed Central 16.08.2024; BMC
• Subjects: Angiography; Angiography-derived index of microcirculatory resistance; Cardiovascular disease; Chronic illnesses; Clinical outcomes; Congestive heart failure; Coronary artery disease; Coronary microvascular dysfunction; Coronary vessels; Death; Diabetes; Diabetes mellitus; Fatalities; Health risk assessment; Heart attacks; Hospitals; Hypertension; Medical imaging; Medical records; Microvasculature; Mortality; Myocardial infarction; Non-ST-segment elevation myocardial infarction; Patients; China
• ISSN: 1475-2840; 1475-2840
• DOI: 10.1186/s12933-024-02400-1

BackgroundDiabetes mellitus (DM) and coronary microvascular dysfunction (CMD) increase the risk of adverse cardiac events in patients with non-ST-segment elevation myocardial infarction (NSTEMI). This study aimed to evaluate the combined risk estimates of DM and CMD, assessed by the angiography-derived index of microcirculatory resistance (angio-IMR), in patients with NSTEMI.MethodsA total of 2212 patients with NSTEMI who underwent successful percutaneous coronary intervention (PCI) were retrospectively enrolled from three centers. The primary outcome was a composite of cardiac death or readmission for heart failure at a 2-year follow-up.ResultsPost-PCI angio-IMR did not significantly differ between the DM group and the non-DM group (20.13 [17.91–22.70] vs. 20.19 [18.14–22.77], P = 0.530). DM patients exhibited a notably higher risk of cardiac death or readmission for heart failure at 2 years compared to non-DM patients (9.5% vs. 5.4%, P < 0.001). NSTEMI patients with both DM and CMD experienced the highest cumulative incidence of cardiac death or readmission for heart failure at 2 years (24.0%, P < 0.001). The combination of DM and CMD in NSTEMI patients were identified as the most powerful independent predictor for cardiac death or readmission for heart failure at 2 years (adjusted HR: 7.894, [95% CI, 4.251–14.659], p < 0.001).ConclusionsIn patients with NSTEMI, the combination of DM and CMD is an independent predictor of cardiac death or readmission for heart failure. Angio-IMR could be used as an additional evaluation tool for the management of NSTEMI patients with DM.Trial registrationURL: https://www.clinicaltrials.gov; Unique identifier: NCT05696379.