{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:14:56Z","timestamp":1789172096308,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T00:00:00Z","timestamp":1779580800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82470339"],"award-info":[{"award-number":["82470339"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to assess the association of coronary microvascular dysfunction (CMD) assessed by the angiography\u2010derived index of microcirculatory resistance (angio\u2010IMR) with long\u2010term cardiovascular outcomes in ST\u2010elevation myocardial infarction (STEMI) patients stratified by obesity categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      In this multicentre prospective cohort, STEMI patients undergoing primary percutaneous coronary intervention (PPCI) were enrolled. Patients were stratified by obesity categories (healthy weight: BMI\u2009&lt;\u200924\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; overweight: 24\u201328\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; obesity: \u2265\u200928\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). CMD was defined as angio\u2010IMR\u2009&gt;\u200940\u2009U.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 497 STEMI patients, CMD prevalence was comparable across BMI groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.875). The cumulative incidence of MACCE was significantly higher in the CMD group than in the non\u2010CMD group among patients with obesity (33.3% vs. 15.0%, log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016), but not among those with overweight (19.6% vs. 15.9%, log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.565) and healthy weight (20.7% vs. 17.4%, log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.673). CMD independently predicted MACCE in obesity (adjusted HR;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020), with consistent results for continuous angio\u2010IMR (adjusted HR 1.03,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). No associations existed in patients with overweight or healthy weight. Additionally, CMD was associated with a higher prevalence of intramyocardial haemorrhage exclusively in obesity (adjusted OR 4.40,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and overweight (adjusted OR 2.65,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CMD assessed by angio\u2010IMR is an independent predictor of MACCE in STEMI patients with obesity, but not those without obesity. Patients with obesity and STEMI who have CMD may represent a high\u2010risk subgroup for future trials of microvascular\u2010protective therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70848","type":"journal-article","created":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T23:45:40Z","timestamp":1779666340000},"page":"6950-6958","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Implications of Coronary Microvascular Dysfunction in\n                    <scp>ST<\/scp>\n                    \u2010Elevation Myocardial Infarction by Obesity Status"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8377-2633","authenticated-orcid":false,"given":"Qian","family":"Guo","sequence":"first","affiliation":[{"name":"Division of Cardiology, Beijing Anzhen Hospital, National Clinical Research Center for Cardiovascular Diseases Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingying","family":"Guo","sequence":"additional","affiliation":[{"name":"Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shutian","family":"Shi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Beijing Anzhen Hospital, National Clinical Research Center for Cardiovascular Diseases Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Beijing Anzhen Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Que","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Beijing Anzhen Hospital, National Clinical Research Center for Cardiovascular Diseases Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoping","family":"Nie","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Beijing Anzhen Hospital, National Clinical Research Center for Cardiovascular Diseases Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8499-0448","authenticated-orcid":false,"given":"Lei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Beijing Anzhen Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deyong","family":"Long","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Beijing Anzhen Hospital, National Clinical Research Center for Cardiovascular Diseases Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Wang","sequence":"additional","affiliation":[{"name":"Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,24]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(21)00045-0"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.09.030"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000973"},{"issue":"12","key":"e_1_2_13_5_1","first-page":"3407306","article-title":"The Impact of Obesity on the Cardiovascular System","volume":"2018","author":"Csige I.","year":"2018","journal-title":"Journal Diabetes Research"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.12.068"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-023-00953-4"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.05.049"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2025.05.001"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2023.04.011"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1514009"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2015.176"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx393"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.08.1038"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.09.064"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvz289"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2021.05.027"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(21)00047-4"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12350-015-0209-1"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw128"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2024.04.048"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2021.05.027"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2021.02.023"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-024-02400-1"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.922264"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-023-01846-z"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.116.005670"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2020.02.004"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2023.07.014"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae827"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2025.101647"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.15212\/CVIA.2024.0065"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad821"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2024.02.003"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2014.06.012"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jey101"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.02.018"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jead141"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-020-01831-7"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2023.03.016"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.125.074645"}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.70848","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dom.70848","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.70848","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:43:18Z","timestamp":1789170198000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.onlinelibrary.wiley.com\/doi\/10.1111\/dom.70848"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,24]]},"references-count":40,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/dom.70848"],"URL":"https:\/\/doi.org\/10.1111\/dom.70848","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/DOM.70848\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70848\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70848\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70848\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70848\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70848\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70848\/v3\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70848\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.70848\/v3\/response1","asserted-by":"object"}]},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"value":"1462-8902","type":"print"},{"value":"1463-1326","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,24]]},"assertion":[{"value":"2026-01-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}