Stress and rest myocardial blood flow to complement myocardial flow reserve in risk prediction for patients being evaluated for known or suspected coronary artery disease
Authors' conclusion
Complementing MFR with rest and stress MBF may improve risk-stratification across different outcomes compared with using MFR only.
Study context
- Population
- Consecutive patients undergoing positron emission tomography (PET) myocardial perfusion imaging (MPI) between 2019 and 2025, being evaluated for known or suspected coronary artery diseasemedian follow-up of 617 days (IQR: 225–1081 days)
- Participants
- 9,296 patients
- Comparison
- Incremental prognostic value of rest and stress myocardial blood flow (MBF) with and without adjustment for myocardial flow reserve (MFR)
- Outcome
- Coprimary outcomes: death/HF hospitalization (rest MBF); MI/late revascularization (stress MBF)
- Follow-up
- Median 617 days
Methodological detailsconsecutive patients, restricted cubic splines, hazard ratios comparing the 75th vs. 25th percentiles
- Consecutive patients
- Restricted cubic splines
- Hazard ratios comparing the 75th vs. 25th percentiles
Main finding
As reported in the abstract
Hazard ratio (95% CI)
Rest MBF 75th percentile vs 25th percentiledeath/HF hospitalization, before adjustment for MFR
1.55(1.29–1.87)
Rest MBF 75th percentile vs 25th percentiledeath/HF hospitalization, after adjustment for MFR
1.36(1.12–1.65)
Stress MBF 75th percentile vs 25th percentileMI/late revascularization, before adjustment for MFR
2.44(1.75–3.40)
Stress MBF 75th percentile vs 25th percentileMI/late revascularization, after adjustment for MFR
1.58(1.10–2.28)
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Stress MBF: late revascularization and MI separatelyStress MBF 75th percentile vs 25th percentile · late revascularization | 1.85 (1.24–2.75) | |
| Stress MBF: late revascularization and MI separatelyStress MBF 75th percentile vs 25th percentile · MI | 1.04 (0.55–1.94) | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Stress and rest myocardial blood flow to complement myocardial flow reserve in risk prediction for patients being evaluated for known or suspected coronary artery disease. Eur Heart J Cardiovasc Imaging. Published 29 December 2025. doi:10.
Summarised from the published abstract; every number is checked against it