“Coronary microcirculation status as predictor of left ventricular dysfunction and heart failure in patients with acute myocardial infarction treated with primary PCI”
Principal investigator:

Prof. dr Goran Stanković
Work package coordinators:

Prof. dr Milika Ašanin

Prof. dr Marija Zdravković

Prof. dr Danijela Zamaklar-Trifunović

Doc. dr Marija Polovina

Prof. dr Gordana Krljanac
About project:
Ischemic heart disease is a recognized major cause of chronic heart failure (HF). Although the widespread availability of primary percutaneous coronary intervention (PCI) has resulted in improved outcomes in recent years, patients with incomplete ST-segment resolution, a surrogate of inadequate myocardial reperfusion, are at an increased risk of developing HF. These clinical observations are well aligned with the findings already generated in the early reperfusion era suggesting that up to 50% of patients with ST-elevation myocardial infarction (STEMI) show signs of coronary microvascular impairment, which has been associated with poor left ventricular (LV) function and larger infarct size.
The primary objective of the SINERGY-ACUTE project is to comparatively assess the association of invasive vs. echocardiography-derived vs. cardiac magnetic resonance (CMR)-based indices of coronary microcirculation with left ventricular (LV) dysfunction. The secondary objective is to measure the relative impact of microvascular dysfunction, CMR-based infarct size, and clinical characteristics on the occurrence of chronic HF after STEMI.
In terms of scientific methodology, we plan to include 2000 consecutive STEMI patients treated with primary PCI, of which 100 will undergo multi-modality coronary microcirculation assessment and 600 will be evaluated with CMR.
We expect the results of our project to provide novel data that compare different modalities of coronary microcirculation assessment after STEMI and their capacity to predict LV dysfunction. In addition, we expect to provide a risk-profiling framework for identifying patients at risk of developing HF after STEMI. Furthermore, our project may have a societal, economic, and healthcare impact by providing contemporary data on the incidence and predictors of HF after STEMI, given that cardiovascular diseases constitute a leading cause of death in Serbia.
Session at Sinergy 2024:
Publications and dissemination:
Myocardial Infarction and Multivessel Disease: Complete Revascularization at the Right Time
DOI: 10.1016/j.jscai.2024.102512
https://www.jscai.org/article/S2772-9303(24)02201-4/fulltext
Correlation of Non-Invasive Transthoracic Doppler Echocardiography with Invasive Doppler Wire-Derived Coronary Flow Reserve and Their Impact on Infarct Size in Patients with ST-Segment Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention
DOI: 10.3390/jcm13092484