{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:53:25Z","timestamp":1793073205568,"version":"4.5.0"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Infarct size (IS) and microvascular obstruction (MVO), measured by cardiovascular magnetic resonance, are key prognostic markers after myocardial infarction (MI). The index of microcirculatory resistance (IMR) predicts MVO and IS; however, its role in MI with nonobstructive coronary arteries (MINOCA) is unclear. This study explored the relationship between coronary angiography\u2010derived IMR, MVO, and IS in true MINOCA and assessed the prognostic value of coronary microvascular dysfunction (CMD), IS, and MVO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with suspected MINOCA who completed cardiovascular magnetic resonance and coronary angiography\u2010derived IMR were included. CMD was defined as coronary angiography\u2010derived IMR &gt;25, and IS as a percentage of left ventricular mass (IS%LV) measured by late gadolinium enhancement. True MINOCA was identified by cardiovascular magnetic resonance evidence of ischemia or infarction. Individuals with true MINOCA were divided into 3 groups: non\u2010CMD and IS%LV &lt;16.78%, CMD or IS%LV \u226516.78%, and CMD with IS%LV \u226516.78%. Follow\u2010up for major adverse cardiovascular events was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Of 317 patients, 102 had true MINOCA (91.2% non\u2013ST\u2010segment\u2013elevation MI). CMD was similarly distributed across all suspected MINOCA. Coronary angiography\u2010derived IMR did not predict MVO or IS among true MINOCA. Over a median 27\u2009months, 33.3% of patients with true MINOCA experienced major adverse cardiovascular events, with a higher risk in patients with CMD or IS%LV \u226516.78%. Multivariate Cox analysis revealed that CMD combined with IS%LV \u226516.78% had a hazard ratio (HR) of 7.40 (95% CI, 1.94\u201328.23), and either CMD or IS%LV \u226516.78% had an HR of 8.77 (95% CI, 2.57\u201329.94), but MVO did not. Sensitivity analyses excluding ST\u2010segment\u2013elevation MI supported these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">CMD with larger IS strongly predicts major adverse cardiovascular events in MINOCA, underscoring their utility in risk stratification, especially for non\u2013ST\u2010segment\u2013elevation MI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>REGISTRATION<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\">https:\/\/clinicaltrials.gov<\/jats:ext-link>\n                      . Unique identifier: NCT06502899.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.043169","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T04:14:23Z","timestamp":1766117663000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Prognostic Impact of Infarct Size and Coronary Microvascular Function Via Cardiovascular Magnetic Resonance and Coronary Angiography\u2010Derived Index of Microcirculatory Resistance in Myocardial Infarction With Nonobstructive Coronary Arteries"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3222-4709","authenticated-orcid":false,"given":"Fuad A.","family":"Abdu","sequence":"first","affiliation":[{"name":"Shanghai Tenth People\u2019s Hospital, Tongji University School of Medicine","place":["Shanghai, 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