Coronary disease & ACSCohort study
Coronary flow capacity and survival prediction after revascularization: physiological basis and clinical implications
- Prospective cohort study
Authors' conclusion
Severely reduced CFC and associated observed survival probability improved after first and repeat revascularization compared with no revascularization for comparable CFC severity. Non-severe CFC showed no benefit.
Study context
- Population
- Coronary artery disease (CAD) subjects with Rb-82 positron emission tomography (PET) quantification of stress myocardial perfusion and coronary flow reserve (CFR) for coronary flow capacity (CFC) maps
- Participants
- 6,979 subjects
- Exposure
- Revascularization vs no revascularization, by CFC severity
- Outcome
- CFC-associated survival probability per decade
Main finding
As reported in the abstract
Low survival probability improved by 42% after revascularization vs no revascularization for comparable severity
P = .0015
Observational data: associations, not effects.
Further findings
Pre- and post-procedure PET pairs (n = 283)
- Severely reduced regional CFC-associated survival probability improved heterogeneously after revascularization
- P < 0.001
- Greater improvement after bypass surgery than PCI
- P < 0.001
- Normalized in only
- 5.7%
- Non-severe baseline CFC or survival probability did not improve vs severe CFC
- P = 0.00001
Observed vs virtual ideal complete post-revascularization survival probability
- Observed lower than virtual, due to residual CAD or failed revascularization; unrelated to gender or microvascular dysfunction
- P < 0.001
Repeat revascularization in post-revascularization subjects with severely reduced CFC (n = 2552)
- Survival probability improved after repeat revascularization vs no repeat procedures
- P = 0.025
Original publication
Summarised from the published abstract; every number is checked against it