Objective To explore the predictive value of myocardial contrast echocardiography (MCE) in quantitative evaluating the microcirculation perfusion in infarcted and non-infarcted segments after direct percutaneous coronary intervention (PPCI) for major adverse cardiovascular events (MACE) in the near future.

Methods From February 2022 to March 2023, 80 patients with acute myocardial infarction (AMI) in our chest pain center were selected. All patients received MCE within 48 hours after operation, and were followed up for one year.The patients were grouped according to whether MACE occurred during the follow-up period, namely the occurrence group (15 cases) and non-occurrence group (65 cases). The area under the curve, peak intensity (PI), time to peak (TTP) and curve slope (WIS) of microcirculation perfusion in the postoperative infarcted and non-infarcted segments under MCE in two groups were quantitatively evaluated and compared. The logistic regression analysis was used to screen the factors of concurrent MACE occurrence, and the receiver operating characteristic (ROC) curve was plotted to analyze its predictive value.

Results The incidence of MACE after surgery was 18.75%. There was no statistical significance in the basic clinical data between the occurrence group and non-occurrence group (P ＞ 0.05). According to the MCE analysis, there was no statistical significance in the non-infarcted segment parameters between two groups (P ＞ 0.05). When comparing the infarcted segments after PPCI between two groups, it was found that the WIS, PI and AUC parameters in the occurrence group were lower than those in non-occurrence group, while the TTP parameter was higher than that in non-occurrence group, and the difference was statistically significant (P ＜ 0.05). The results of logistic regression analysis showed that the WIS increasing (OR: 2.541, 95%CI: 1.362–4.739), PI increasing (OR: 2.209, 95%CI: 1.241–3.931) and AUC increasing (OR: 2.394, 95%CI: 1.289–4.447) were the risk factors of concurrent MACE (OR ＞ 1, P ＜ 0.05), and the TTP increasing (OR: 0.582, 95%CI: 0.424–0.800) was a protective factor of concurrent MACE (OR ＜ 1, P ＜ 0.05). The results of ROC analysis showed that the areas under the curves of myocardial angiography parameters (WIS, TTP, PI, AUC) were all ＞ 0.600.

Conclusions The quantitative assessment of microcirculation perfusion parameters such as WIS, TTP, PI, and AUC in the infarcted segment after PPCI by MCE has a good predictive value for concurrent MACE.