Prognostic Value of PET-Derived Myocardial Flow Reserve in Patients With Very High Coronary Artery Calcium Score
Authors' conclusion
Among patients with CAC ≥400, positron emission tomography-derived MFR ≥2 is inversely associated with a lower risk of all-cause death and myocardial infarction.
Study context
- Population
- Patients with coronary artery calcium (CAC) ≥400 who had a clinically indicated positron emission tomographystudy population
- Participants
- 3,091 patients
- Exposure
- Association between myocardial flow reserve (MFR) and incident events among those with CAC ≥400
- CAC score of 400 to 999n = 46.0%
- CAC score of ≥1000n = 54.0%
- Outcome
- Incident events:
- All-cause death
- Myocardial infarction
- Follow-up
- Median (interquartile range) of 1.36 (0.45-2.50) years
Methodological detailsconsecutive patients, clinically indicated positron emission tomography, multivariable-adjusted Cox proportional hazards models
- Consecutive patients
- Clinically indicated positron emission tomography
- Multivariable-adjusted Cox proportional hazards models
Main finding
As reported in the abstract
MFR ≥2Hazard ratio (95% CI)
CAC score of 400 to 999; adjusted
0.65(0.38–1.12)
CAC score of ≥ 1000; adjusted
0.44(0.28–0.69)
- Incident events
- 278
- Myocardial infarctions
- 81
- Deaths
- 217
Observational data: associations, not effects.
Further findings
- Median (interquartile range) MFR
- 1.9 (1.45-2.35)
Original publication
Prognostic Value of PET-Derived Myocardial Flow Reserve in Patients With Very High Coronary Artery Calcium Score. Circ Cardiovasc Imaging. Published 7 August 2025. doi:10.
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