Prognostic impact of coronary microvascular dysfunction assessed by AMR in acute coronary syndrome patients with chronic kidney disease
BackgroundAngiography-derived microcirculatory resistance (AMR) is proposed as a novel, pressure- temperature-wire-free and less-invasive method to evaluate coronary microvascular dysfunction (CMD). This study aims to examine the prognostic role of CMD assessed by AMR in predicting adverse events in...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1489403/full |
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| author | Ziyu Guo Yike Li Qiang Chen Jingang Zheng Jingang Zheng |
| author_facet | Ziyu Guo Yike Li Qiang Chen Jingang Zheng Jingang Zheng |
| author_sort | Ziyu Guo |
| collection | DOAJ |
| description | BackgroundAngiography-derived microcirculatory resistance (AMR) is proposed as a novel, pressure- temperature-wire-free and less-invasive method to evaluate coronary microvascular dysfunction (CMD). This study aims to examine the prognostic role of CMD assessed by AMR in predicting adverse events in acute coronary syndrome (ACS) patients with chronic kidney disease (CKD).MethodsThis retrospective cohort study included ACS with CKD patients in the China-Japan Friendship Hospital from January 2016 to November 2022. The patients were divided into CMD and non-CMD groups based on AMR values of less than or greater than 250 mmHg*s/m.ResultsA total of 345 eligible patients were included in this study. During a median follow-up of 23.0 months, higher prevalence rate of MACEs (28.3% vs. 15.1%, P = 0.003) and death (20.2% vs. 4.1%, P = 0.001) were observed in the CMD group. In multivariate Cox regression analysis, patients in the group of CMD had a 1.843 times higher hazard ratio (HR) for developing MACEs (HR: 1.843, 95% CI: 1.071–3.174, P = 0.027) and 5.325 times higher HR for developing death (HR: 5.325, 95% CI: 1.979–14.327, P < 0.001) for every 10 mmHg*s/m increment in AMR. The incorporation of AMR improved the predictive accuracy of the GRACE score for MACEs and death.ConclusionThis study indicates that the AMR is significantly related to poor prognosis among patients with ACS and CKD. Furthermore, AMR could improve the predictive power of the GRACE risk score. These results indicated that AMR may serve as a valuable clinical tool for classification, risk stratification or therapy individualization in these patients. |
| format | Article |
| id | doaj-art-16009019b1134f629d5c31a3183800bf |
| institution | Kabale University |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-16009019b1134f629d5c31a3183800bf2025-01-07T06:40:58ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-01-011110.3389/fcvm.2024.14894031489403Prognostic impact of coronary microvascular dysfunction assessed by AMR in acute coronary syndrome patients with chronic kidney diseaseZiyu Guo0Yike Li1Qiang Chen2Jingang Zheng3Jingang Zheng4Department of Cardiology, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, ChinaDepartment of Cardiology, China-Japan Friendship Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaGraduate School of Peking Union Medical College, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Cardiology, Peking University China-Japan Friendship School of Clinical Medicine, Beijing, ChinaDepartment of Cardiology, China-Japan Friendship Hospital, Beijing, ChinaBackgroundAngiography-derived microcirculatory resistance (AMR) is proposed as a novel, pressure- temperature-wire-free and less-invasive method to evaluate coronary microvascular dysfunction (CMD). This study aims to examine the prognostic role of CMD assessed by AMR in predicting adverse events in acute coronary syndrome (ACS) patients with chronic kidney disease (CKD).MethodsThis retrospective cohort study included ACS with CKD patients in the China-Japan Friendship Hospital from January 2016 to November 2022. The patients were divided into CMD and non-CMD groups based on AMR values of less than or greater than 250 mmHg*s/m.ResultsA total of 345 eligible patients were included in this study. During a median follow-up of 23.0 months, higher prevalence rate of MACEs (28.3% vs. 15.1%, P = 0.003) and death (20.2% vs. 4.1%, P = 0.001) were observed in the CMD group. In multivariate Cox regression analysis, patients in the group of CMD had a 1.843 times higher hazard ratio (HR) for developing MACEs (HR: 1.843, 95% CI: 1.071–3.174, P = 0.027) and 5.325 times higher HR for developing death (HR: 5.325, 95% CI: 1.979–14.327, P < 0.001) for every 10 mmHg*s/m increment in AMR. The incorporation of AMR improved the predictive accuracy of the GRACE score for MACEs and death.ConclusionThis study indicates that the AMR is significantly related to poor prognosis among patients with ACS and CKD. Furthermore, AMR could improve the predictive power of the GRACE risk score. These results indicated that AMR may serve as a valuable clinical tool for classification, risk stratification or therapy individualization in these patients.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1489403/fullcoronary microvascular dysfunctionangiography-derived microvascular resistance (AMR)acute coronary syndromechronic kidney diseaseMACEsall-cause mortality |
| spellingShingle | Ziyu Guo Yike Li Qiang Chen Jingang Zheng Jingang Zheng Prognostic impact of coronary microvascular dysfunction assessed by AMR in acute coronary syndrome patients with chronic kidney disease Frontiers in Cardiovascular Medicine coronary microvascular dysfunction angiography-derived microvascular resistance (AMR) acute coronary syndrome chronic kidney disease MACEs all-cause mortality |
| title | Prognostic impact of coronary microvascular dysfunction assessed by AMR in acute coronary syndrome patients with chronic kidney disease |
| title_full | Prognostic impact of coronary microvascular dysfunction assessed by AMR in acute coronary syndrome patients with chronic kidney disease |
| title_fullStr | Prognostic impact of coronary microvascular dysfunction assessed by AMR in acute coronary syndrome patients with chronic kidney disease |
| title_full_unstemmed | Prognostic impact of coronary microvascular dysfunction assessed by AMR in acute coronary syndrome patients with chronic kidney disease |
| title_short | Prognostic impact of coronary microvascular dysfunction assessed by AMR in acute coronary syndrome patients with chronic kidney disease |
| title_sort | prognostic impact of coronary microvascular dysfunction assessed by amr in acute coronary syndrome patients with chronic kidney disease |
| topic | coronary microvascular dysfunction angiography-derived microvascular resistance (AMR) acute coronary syndrome chronic kidney disease MACEs all-cause mortality |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2024.1489403/full |
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