Study on the Improvement of Myocardial Microcirculation After Acute Anterior Myocardial Infarction

Inclusion criteria

Clinical Inclusion Criteria:

• Subjects aged ≥18 years;
• Initial diagnosis of anterior wall ST-segment elevation myocardial infarction, with symptoms occurring within 6 hours, and undergoing primarypercutaneous coronary intervention (PCI);
• Subjects (or legal representatives) who understand the study requirements and treatment procedures and provide signed informed consent.

Imaging Inclusion Criteria (Visual Estimation):

• Target lesion is the culprit lesion, located in the native coronary artery, with a visually estimated reference vessel diameter (RVD) between 2.25 mm and 4.0 mm;
• Culprit segment of the infarct-related artery (IRA) is located between the origin of the left anterior descending (LAD) artery and the emergence of the second diagonal branch (D2);
• After pre-treatment , the degree of stenosis in the LAD is ≤90%, and TIMI flow is grade 3.

Exclusion criteria

Clinical Exclusion Criteria:

• History of coronary artery bypass grafting (CABG);
• Known history of myocardial infarction or PCI;
• Previous thrombolytic therapy before PCI;
• Severe liver or kidney dysfunction, severe valvular heart disease, chronic obstructive pulmonary disease, etc.;
• Contraindications to magnetic resonance imaging;
• Allergy to gadolinium contrast agents and/or accompanying medications for devices or procedures (e.g., any component of drug-eluting stents, all P2Y12 inhibitors, or aspirin);
• Expected lifespan of the subject less than 12 months;
• Pregnant or lactating females;
• Other subjects deemed unsuitable for participation in the study by the investigator.

Imaging Exclusion Criteria (Visual Estimation):

• Presence of lesions requiring intervention other than the target lesion at baseline surgery;
• No protected left main coronary artery disease (visual estimate of stenosis >50%);
• Diffuse severe calcification (>20 mm) or chronic total occlusion in the major coronary vessels (LCX, RCA);
• Severe coronary artery tortuosity (>45°) or calcification (>270°), or other conditions that may interfere with the use of intravascular imaging.