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After primary PCI was completed, intracoronary nitroglycerin (100-200 μg) was administered and a coronary pressure wire (St. Jude Medical) was calibrated, equalized to the guide catheter Background-Most methods for assessing microvascular function are not readily available in the cardiac catheterization laboratory. The aim of this study is to determine whether the Index of Microcirculatory Resistance (IMR), measured at the time of primary percutaneous coronary intervention, is predictive of death and rehospitalization for heart failure. Methods and Results-IMR was measured immediately after primary percutaneous coronary intervention in 253 patients from 3 institutions with the use of a pressure-temperature sensor wire. The primary end point was the rate of death or rehospitalization for heart failure.