The ATI score (age-thrombus burden-index of microcirculatory resistance) determined during primary percutaneous coronary intervention predicts final infarct size in patients with ST-elevation myocardial infarction: a cardiac magnetic resonance validation study

EuroIntervention. 2017 Oct 20;13(8):935-943. doi: 10.4244/EIJ-D-17-00367.


Aims: The age-thrombus burden-index of microcirculatory resistance (ATI) score is a diagnostic tool able to predict suboptimal myocardial reperfusion before stenting, in patients with ST-elevation myocardial infarction (STEMI). We aimed to validate the ATI score against cardiac magnetic resonance imaging (cMRI).

Methods and results: The ATI score was calculated prospectively in 80 STEMI patients. cMRI was performed within 48 hours in all patients and in 50 patients at six-month follow-up to assess the extent of infarct size (IS%) and microvascular obstruction (MVO%). The ATI score was calculated using age (>50=1 point), pre-stenting index of microcirculatory resistance (IMR) (>40 and <100=1 point; ≥100=2 points) and angiographic thrombus score (4=1 point; 5=3 points). ATI score was closely related to final IS% (ATI.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Coronary Circulation / physiology
  • Female
  • Humans
  • Magnetic Resonance Imaging* / methods
  • Male
  • Microcirculation / physiology*
  • Middle Aged
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / physiopathology
  • Myocardial Reperfusion / methods
  • Percutaneous Coronary Intervention* / methods
  • ST Elevation Myocardial Infarction / diagnostic imaging*
  • ST Elevation Myocardial Infarction / physiopathology
  • Treatment Outcome