Incremental prognostic value of positron emission tomography-derived myocardial flow reserve in patients with and without diabetes mellitus
Authors' conclusion
PET-derived MFR has a strong independent and incremental prognostic role in patients with diabetes and those without diabetes.
Study context
- Population
- Consecutive patients with clinically indicated positron emission tomography (PET) MPI for suspected or established coronary artery disease (CAD), with and without diabetes63% with diabetes
- Participants
- 6,019 patients
- Exposure
- Impaired myocardial flow reserve (MFR) vs preserved MFR, in patients with and without diabetes
- Outcome
- Composite of:
- All-cause death
- MI
- Unplanned PCI/CABG >90 days after imaging
- Follow-up
- Median 22.6 (7.8-42.5) months
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Primary outcome, by diabetes status
Impaired MFR vs Preserved MFRHazard ratio (95% CI)P value
Diabetes
1.8(1.4–2.3)
P < 0.001No diabetes
1.4(1.0–2.1)
P = 0.046- No interaction between diabetes status and MFR
- P = 0.234
- Patients with primary outcome (overall)
- 619 (10%, 3.8 per 1000 person-years)
- Impaired MFR (<2) prevalence
- 53%
Observational data: associations, not effects.
Further findings
Subgroups with no CAD and normal perfusion study
- Results consistent across subgroups
Original publication
Incremental prognostic value of positron emission tomography-derived myocardial flow reserve in patients with and without diabetes mellitus. Eur Heart J Cardiovasc Imaging. Published 23 February 2023. doi:10.
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