The following is a summary of “Angiography-based coronary microvascular assessment with and without intracoronary pressure measurements: a systematic review,” published in the November 2023 issue of Cardiology by Kest et al.
Numerous indices have emerged to quantify coronary microvascular resistance, necessitating a comprehensive review of angiography-derived microvascular resistance indices.
Researchers conducted a retrospective study to identify, analyze, and compare the limits of agreement and advantages of angiography-derived microvascular resistance indices against an invasive reference method.
They searched PubMed from its inception (2022) to identify studies on diverse methods for quantifying microvascular resistance; 7 studies met the inclusion criteria, and 5 studies exclusively used invasive angiography techniques, validated against invasively measured thermodilution-derived microvascular resistance index. While 2 studies combined angiography with invasively measured intracoronary pressure data, validated against invasive Doppler measurements.
The results showed ± 1.96 standard deviation limits of agreement with the reference method from the 7 studies, which were converted into percentages relative to the reference method’s cut-off value. Angiography-based methods had lower limits of agreement from -122% to -60% and upper limits from 74% to 135%.In contrast, the limits of agreement for the two combined angiography- and pressure-based methods were narrower, ranging from -52% to 60% and -25% to 27%.
Investigators concluded that combined angiography- and pressure-based methods outperformed angiography-only methods in reliably assessing microvascular resistance.
Source: link.springer.com/article/10.1007/s00392-023-02338-6#Abs1
