Evidence map›Paper›PMID 40653473›Full record

ArticleBMC cardiovascular disorders2025

Microcirculatory resistance index based on a single angiographic view predicts long-term prognosis following rotational atherectomy in patients with acute coronary syndrome.

Xinbo Bai, Xiaohua Yu, Yufang Li, Zhe Zhang, Xuemei Guo, Yanan Xue, Luwa Gao, Kun Wang, Zhonghai Wei, Qing Dai and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Xinbo Bai *Department of Cardiology, Nanjing Key Laboratory for Cardiovascular Information and Health Engineering Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210093, China.
Xiaohua Yu *Department of Cardiology, Clinical College of Nanjing, Nanjing Drum Hospital, University of Chinese Medicine, Nanjing, China.
Yufang Li *Department of Cardiology, Nanjing Key Laboratory for Cardiovascular Information and Health Engineering Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210093, China.
Zhe ZhangDepartment of Cardiology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China.
Xuemei GuoDepartment of Cardiology, Nanjing Key Laboratory for Cardiovascular Information and Health Engineering Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210093, China.
Yanan XueDepartment of Cardiology, Nanjing Key Laboratory for Cardiovascular Information and Health Engineering Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210093, China.
Luwa GaoDepartment of Cardiology, Nanjing Key Laboratory for Cardiovascular Information and Health Engineering Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210093, China.
Kun WangDepartment of Cardiology, Nanjing Key Laboratory for Cardiovascular Information and Health Engineering Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210093, China.
Zhonghai WeiDepartment of Cardiology, Nanjing Key Laboratory for Cardiovascular Information and Health Engineering Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210093, China.
Qing DaiDepartment of Cardiology, Nanjing Key Laboratory for Cardiovascular Information and Health Engineering Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210093, China.
Biao XuDepartment of Cardiology, Nanjing Key Laboratory for Cardiovascular Information and Health Engineering Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210093, China. xubiao62@nju.edu.cn.
Lina KangDepartment of Cardiology, Nanjing Key Laboratory for Cardiovascular Information and Health Engineering Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210093, China. kanglina@njglyy.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo explore the long-term predictive value of the angiographic microcirculatory resistance (AMR) index for patients with acute coronary syndrome (ACS) undergoing rotational atherectomy (RA).

methodsA total of 344 ACS patients undergoing RA during percutaneous coronary intervention (PCI) at Nanjing Drum Tower Hospital between December 1, 2011 and December 1, 2022 were retrospectively analyzed. AMR of the target vessel was measured, and the incidence of major adverse cardiac and cerebral events (MACCEs) was analyzed as the primary endpoints. MACCEs encompassed cardiovascular mortality, non-fatal myocardial infarction (MI), target vessel revascularization (TVR), worsening heart failure (WHF), and ischemic stroke (IS). Patients were divided into the MACCEs group and the non-MACCEs group based on the occurrence of MACCEs. Univariate and multivariate Cox regression analyses were conducted to determine factors linked to MACCEs. Moreover, patients categorized based on the median AMR value into the high-AMR group and the low-AMR group. We conducted Kaplan-Meier curve analysis to assess the differences in the cumulative event rates between patients in the high-AMR group and the low-AMR group during long-term follow-up. Utilizing restricted cubic spline (RCS) curves, we further validated the relationship between AMR and the occurrence of MACCEs.

resultsAfter the completion of a median follow-up time of 39 months, 268 ACS patients undergoing RA were included in the final analysis, of whom 53 (19.78%) experienced MACCEs. Compared with the non-MACCEs group, the MACCEs group exhibited a significantly higher AMR post-RA (P < 0.05). There was no statistically significant difference in clinical presentations between patients in the high-AMR and low-AMR groups. The multivariate Cox regression analysis revealed that AMR following RA was an independent predictor of MACCEs during long-term follow-up (hazard ratio [HR]: 2.364, 95% confidence intervals: 1.394–4.009; P < 0.01). Furthermore, restricted cubic spline analysis revealed a positive correlation between the cumulative risk of primary endpoints and increasing AMR levels. Notably, utilizing AMR as a continuous variable revealed a rapid elevation in HRs for MACCEs within the higher range of AMR (AMR > 2.278) in the long-term.

conclusionsElevated AMR post-RA predicts an increased risk of MACCEs during long-term follow-up in ACS patients.

Indexed as

Acute Coronary SyndromeAtherectomy, CoronaryCoronary AngiographyCoronary CirculationMicrocirculationVascular ResistanceAgedFemaleHumansMaleMiddle AgedPredictive Value of TestsRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsAcute coronary syndromeAngiographic microcirculatory resistanceCalcified lesionCoronary microcirculation dysfunctionRotational atherectomy

Identifiers

PMID40653473
PMCPMC12257679

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