{
  "abstract": "Introduction Coronary wedge pressure (CWP) in STEMI is measured during coronary occlusion, with a distal pressure wire sensor, and can be used to assess the coronary flow pressure index (CFPI = CWP/aortic pressure). Its clinical significance in STEMI, however, remains controversial, with conflicting reports on its predictive value for microvascular obstruction (MVO). Early studies suggested that a higher CFPI correlated with better left ventricular (LV) recovery, while others linked elevated CWP to worse outcomes, including increased LV remodelling and reduced ejection fraction. Given these inconsistencies, we examined a large cohort of anterior STEMI patients with recorded CWP to determine its relationship with MVO as assessed by cardiac MRI (CMR).Methods This retrospective analysis evaluated a subset of patients from the EUROICE trial ( NCT03447834), a multicentre RCT enrolling 200 anterior STEMI patients with occluded proximal/mid-LAD. Patients were randomised 1:1 to selective intracoronary hypothermia (SIH) or standard primary PCI. This sub-analysis focused on the SIH group, assessing coronary wedge pressure using over-the-wire balloon occlusion. We calculated systolic, mean, and diastolic wedge pressures, CFPI, and balloon deflation time. These parameters were correlated with MVO on CMR at 2–7 days.Results Of 82 SIH patients, 73 had interpretable coronary wedge pressure data. Linear regression showed no significant correlation between balloon deflation time (pressure equalisation) and MVO severity (r=-0.209, p=0.085). Similarly, CFPI demonstrated a weak negative correlation with%MVO on CMR (r=-0.12, p=0.37). Systolic, diastolic, and mean coronary wedge pressures also showed slight negative correlations with%MVO (r = -0.21, r = -0.16, and r = -0.22, respectively).Abstract 2-005 Figure 1Abstract 2-005 Figure 2Conclusion This study represents the largest early presenting anterior STEMI cohort with recorded coronary wedge pressure. We found no significant relationship between CFPI and MVO. Currently the index of microvascular resistance (IMR) remains the gold standard for assessing MVO, further refinement of risk stratification tools is necessary to better predict and mitigate adverse outcomes in STEMI patients.",
  "authors": [
    {
      "affiliations": [
        "Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK",
        "Anglia Ruskin School of Medicine & MTRC, Anglia Ruskin University, Chelmsford, UK"
      ],
      "name": "Haroun Butt"
    },
    {
      "affiliations": [
        "Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK",
        "Anglia Ruskin School of Medicine & MTRC, Anglia Ruskin University, Chelmsford, UK"
      ],
      "name": "Abdalla Ibrahim"
    },
    {
      "affiliations": [
        "Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK",
        "Anglia Ruskin School of Medicine & MTRC, Anglia Ruskin University, Chelmsford, UK"
      ],
      "name": "Uzma Sajjad"
    },
    {
      "affiliations": [
        "Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK",
        "Anglia Ruskin School of Medicine & MTRC, Anglia Ruskin University, Chelmsford, UK"
      ],
      "name": "Sam Fawaz"
    },
    {
      "affiliations": [
        "Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK",
        "Anglia Ruskin School of Medicine & MTRC, Anglia Ruskin University, Chelmsford, UK"
      ],
      "name": "Chris Cook"
    },
    {
      "affiliations": [
        "Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK",
        "Anglia Ruskin School of Medicine & MTRC, Anglia Ruskin University, Chelmsford, UK"
      ],
      "name": "Ozan Demir"
    },
    {
      "affiliations": [
        "Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK",
        "Anglia Ruskin School of Medicine & MTRC, Anglia Ruskin University, Chelmsford, UK"
      ],
      "name": "Gerald Clesham"
    },
    {
      "affiliations": [
        "Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK",
        "Anglia Ruskin School of Medicine & MTRC, Anglia Ruskin University, Chelmsford, UK"
      ],
      "name": "Klio Konstantinou"
    },
    {
      "affiliations": [
        "Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK",
        "Anglia Ruskin School of Medicine & MTRC, Anglia Ruskin University, Chelmsford, UK"
      ],
      "name": "Shah Mohdnazri"
    },
    {
      "affiliations": [
        "Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK",
        "Anglia Ruskin School of Medicine & MTRC, Anglia Ruskin University, Chelmsford, UK"
      ],
      "name": "Kare Tang"
    },
    {
      "affiliations": [
        "Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK",
        "Anglia Ruskin School of Medicine & MTRC, Anglia Ruskin University, Chelmsford, UK"
      ],
      "name": "Rohan Jagathesan"
    },
    {
      "affiliations": [
        "Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands"
      ],
      "name": "Konrad van Beek"
    },
    {
      "affiliations": [
        "Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands"
      ],
      "name": "Mohamed El Farissi"
    },
    {
      "affiliations": [
        "Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands"
      ],
      "name": "Luuk Otterspoor"
    },
    {
      "affiliations": [
        "Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands"
      ],
      "name": "Pim Tonino"
    },
    {
      "affiliations": [
        "Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands"
      ],
      "name": "Nico Pijls"
    },
    {
      "affiliations": [
        "Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK",
        "Anglia Ruskin School of Medicine & MTRC, Anglia Ruskin University, Chelmsford, UK"
      ],
      "name": "John R Davies"
    },
    {
      "affiliations": [
        "Department of Cardiology, Essex Cardiothoracic Centre, Basildon, UK",
        "Anglia Ruskin School of Medicine & MTRC, Anglia Ruskin University, Chelmsford, UK"
      ],
      "name": "Thomas R Keeble"
    }
  ],
  "title": "2-005 Coronary wedge pressure and microvascular obstruction in anterior STEMI: a subgroup analysis of the EUROICE study",
  "uid": "f0e8473a-b3a3-5b5c-88a7-19852766dd5e"
}