Analysis Of Relevant For Index Of Microcirculatory Resistance In Patients Without Obstructive Coronary Artery Disease

Objective:To investigate the related factors of the index of microcirculation resistance (IMR) in patients without obstructive coronary artery disease.Materials and Methods:A total of41patients who had symptom of myocardial ischemia such as chest pain but without obstructive coronary artery were involved in this study. All the patients underwent coronary artery angiography (CAG) and the index of microcirculation resistance (IMR) was measured in left anterior descending artery at the time of CAG during October2012to March2014in Subei People’s Hospital of Jiangsu province. All patients were divided into2groups using IMR median as the cut-off. Observation target includes general information (gender, age, BMI), coronary heart disease risk factors (diabetes, hypertension, high cholesterol, smoking) and related biochemical parameters:fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), uric acid (UA), creatinine (CRE); red blood cell count (RBC), hemoglobin concentration (HB), red blood cell volume distribution width (RDW), white blood cell count (WBC), platelet count (PLT) and mean platelet volume (MPV). The factors were compared between these two groups, then univariate and multivariate statistical analysis was done, in order to determine the relationship between IMR and clinical data.Results:IMR varied widely (median,21.7, range from5.4to63.92), and there was no significant relationship between IMR and FFR or coronary stenosis. History of hypertension and MPV were significantly associated with increased IMR. HDL-C was negatively correlated wish IMR. multi-variable logistic regression showed that hypertension(OR=14.168, P=0.023), MPV(OR=3.570, P=0.029)were independent predictors of increased IMR. HDL-C was an independent protective factor of increased IMR(OR=0.001, P=0.034).Conclusion:1. Functional significance of coronary epicardial vessel stenosis was not correlated with coronary microvascular dysfunction assessed by IMR.2. Coronary microvascular dysfunction assessed by IMR was paradoxically poorly predicted by traditional cardiac risk factors. Hypertension and HDL-C were moderate correlation with IMR, and hypertension, lower HDL levels were independent risk factors of increased IMR.3. There was a significant correlation between MPV and IMR, and MPV was an independent risk factor of increased IMR. This article...