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AIMS Novel parameters that detect failed microvascular reperfusion might better identify the patients likely to benefit from adjunctive treatments during primary percutaneous coronary intervention (PCI). We hypothesised that a novel invasive parameter, the thermodilution-derived temperature recovery time (TRT), would be associated with microvascular obstruction (MVO) and prognosis. METHODS AND RESULTS TRT was derived and validated in two independent ST-elevation myocardial infarction populations and was measured immediately post-PCI. T