A hemorheological perspective on coronary microvascular dysfunction: Association of erythrocyte parameters with angiography-derived coronary microcirculatory resistance.
Elevated RBC parameters (RBC count, hematocrit, and hemoglobin) are independently associated with increased angiography-derived microcirculatory resistance, particularly in non-LAD vessels, suggesting RBC parameters may serve as clinically relevant markers of microvascular dysfunction.
Key Findings
Results
Higher RBC count was independently associated with elevated angio-IMR after full multivariable adjustment.
β = 0.182, P < 0.001 in multivariable linear regression
Study included 604 patients comprising 733 lesions with intermediate coronary artery disease (30%–70% stenosis)
RBC parameters were obtained during hospitalization prior to angiography
Coronary microcirculatory resistance was derived using the AngioPlus mQFR system
Results
Higher hematocrit was independently associated with elevated angio-IMR after full multivariable adjustment.
β = 0.019, P < 0.001 in the primary analysis
Results remained robust after excluding hematocrit outliers (β = 0.020, P < 0.001) in sensitivity analyses
The association was consistent across both diabetic (P = 0.007) and non-diabetic subgroups (P = 0.012)
Results
Higher hemoglobin was independently associated with elevated angio-IMR after full multivariable adjustment.
β = 0.006, P < 0.001 in multivariable linear regression models adjusted for confounders
This association was evaluated in the same retrospective cohort of 604 patients with 733 lesions
Results
The association between hematocrit and microcirculatory resistance was significant in non-LAD vessels but not in LAD lesions.
Non-LAD vessels: Hct β = 0.022, P < 0.001
LAD lesions: Hct β = 0.008, P = 0.357 (non-significant)
Subgroup analyses were stratified by vessel: left anterior descending (LAD), left circumflex (LCx), and right coronary artery (RCA)
Results
The association between RBC parameters and angio-IMR was consistent across diabetic and non-diabetic subgroups.
Diabetic subgroup: P = 0.007
Non-diabetic subgroup: P = 0.012
Diabetes status was evaluated as a potential effect modifier in subgroup analyses
Methods
The study evaluated RBC parameters in patients with intermediate coronary artery disease using a retrospective design.
604 patients comprising 733 lesions were analyzed
Inclusion criterion was intermediate coronary artery disease defined as 30%–70% stenosis
Angio-IMR was derived using the AngioPlus mQFR system
Multivariable linear regression models were adjusted for confounders
AlQazzaz A, Lu Y, Bao J, Mintz G, Feng J, Zhang Y, et al.. (2026). A hemorheological perspective on coronary microvascular dysfunction: Association of erythrocyte parameters with angiography-derived coronary microcirculatory resistance.. PloS one. https://doi.org/10.1371/journal.pone.0345562