Coronary disease & ACSCohort study
Myocardial blood flow reserve assessed by positron emission tomography myocardial perfusion imaging identifies patients with a survival benefit from early revascularization
- Retrospective cohort study
- consecutive patients
Authors' conclusion
Myocardial blood flow reserve on PET MPI is associated with all-cause mortality and can identify patients who receive a survival benefit with early revascularization compared to medical therapy.
Study context
- Population
- Consecutive patients undergoing Rb82 rest/stress positron emission tomography (PET) myocardial perfusion imaging (MPI), January 2010 to December 2016, excluding cardiomyopathy, prior CABG and missing myocardial blood flow reserve (MBFR)
- Participants
- 12,594 patients
- Exposure
- Early revascularization vs medical therapy, by MBFR on PET MPI
- Early revascularizationn = 897
- Outcome
- All-cause mortality
- Follow-up
- Median 3.2 years
Main finding
All-cause death per 0.1 unit decrease in MBFR
Hazard ratio
1.09
95% CI 1.08–1.10
P < 0.001
Per 0.1 unit decrease in MBFR
HR 1.09 (95% CI 1.08–1.10); P < 0.001
Per 0.1 unit decrease in MBFR, as printed
As reported in the abstract
- Significant interaction between MBFR and early revascularization
- P < 0.001
Observational data: associations, not effects.
Further findings
Deaths · median follow-up 3.2 years
- Patients who died
- 1699 (13.5%)
Ischaemia and MBFR distribution
- Ischaemia present
- 4051 (32.3%)
- ≥10% ischaemia
- 1413 (11.2%)
- Mean MBFR
- 2.0 ± 1.3
- MBFR <1.8
- 4836 (38.5%)
Original publication
Myocardial blood flow reserve assessed by positron emission tomography myocardial perfusion imaging identifies patients with a survival benefit from early revascularization. Eur Heart J. Published 22 June 2019. doi:10.1093/eurheartj/ehz389
Summarised from the published abstract; every number is checked against it