Prognostic Value of Modified Coronary Flow Capacity Derived From [ 15 O]H 2 O Positron Emission Tomography Perfusion Imaging
Authors' conclusion
[15O]H2O positron emission tomography-derived resting myocardial blood flow, hyperemic myocardial blood flow, coronary flow reserve, and CFC are prognostic factors for death and nonfatal myocardial infarction in patients with known or suspected coronary artery disease. Importantly, after adjustment for clinical characteristics and the combined use of [15O]H2O positron emission tomography perfusion metrics, modified CFC remained independently associated with adverse outcome.
Study context
- Population
- Patients with known or suspected CAD undergoing quantitative rest/stress [15O]H2O PET perfusion imaging153 (12%) with end point
- Participants
- 1,300 patients
- Comparison
- Modified coronary flow capacity (CFC) categories vs normal flow on [15O]H2O PET
- Myocardial stealn = 38
- Severely reduced CFCn = 141
- Moderately reduced CFCn = 394
- Minimally reduced CFCn = 245
- Normal flown = 482reference
- Outcome
- Composite of:
- Death
- Nonfatal MI
- Follow-up
- Median 5.5 (IQR 3.7-7.8) years
Performance
As reported in the abstract
Death or nonfatal MI · median 5.5 years
Each group vs normal flowHazard ratio (95% CI)P value
Myocardial steal
6.70(3.21–13.99)
P < 0.001Severely reduced CFC
2.35(1.16–4.78)
P = 0.018Moderately reduced CFC
1.95(1.11–3.41)
P = 0.020- Modified CFC independent prognostic value in model adjusted for combined perfusion metrics
- overall P=0.017
Further findings
Perfusion metrics in overall population (independent association with adverse outcome)
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| Increased resting myocardial blood flow | 3.05 (1.68–5.54) | P < 0.001 | |
| Hyperemic myocardial blood flowDecreased associated with adverse outcome | 0.68 (0.52–0.90) | P = 0.007 | |
| Coronary flow reserveDecreased associated with adverse outcome | 0.55 (0.42–0.71) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Prognostic Value of Modified Coronary Flow Capacity Derived From [ 15 O]H 2 O Positron Emission Tomography Perfusion Imaging. Circ Cardiovasc Imaging. Published 19 September 2023. doi:10.
Summarised from the published abstract; every number is checked against it