Functional coronary microvascular dysfunction, defined as abnormal CFR (<2.5) with normal IMR (<25), was significantly associated with higher all-cause mortality at 5 years (log-rank P <0.0001).
Observational (n=243)
Does functional coronary microvascular dysfunction increase the risk of all-cause mortality in patients with non-obstructive coronary artery disease?
Functional coronary microvascular dysfunction (abnormal CFR with normal IMR) is a significant predictor of 5-year all-cause mortality in patients with non-obstructive coronary artery disease.
p-value: p=<0.0001
Abstract Background Coronary microvascular dysfunction (CMD) has been reported to be associated with adverse cardiovascular events. However, CMD endotypes, which were identified using a combined assessment of coronary flow reserve (CFR) and the index of microvascular resistance (IMR) have not been fully established. Purpose This study aimed to investigate the long-term prognosis of CMD endotypes. Methods We included 378 patients (384 vessels), of whom 243 patients (248 vessels) had non-obstructive coronary artery disease (fractional flow reserve FFR 0.80) and were analyzed. The primary endpoint was all-cause mortality at 5 years. Functional CMD was defined as abnormal CFR (2.5) with normal IMR (25), while structural CMD was defined as abnormal CFR with abnormal IMR. Results In non-obstructive coronary arteries, the median FFR and CFR (Q1, Q3) were 0.88 (0.85, 0.92) and 2.4 (1.8, 3.2), respectively. The median follow-up was 1,829 days. Abnormal CFR was significantly associated with higher long-term mortality (log-rank P = 0.0007), whereas abnormal IMR was not (log-rank P = 0.34). Kaplan-Meier analysis showed significantly higher mortality in the functional CMD group (log-rank P 0.0001). Conclusions Functional CMD, defined as abnormal CFR (2.5) with normal IMR (25), was associated with increased mortality at 5 years.
Yamanaka et al. (Sat,) conducted a observational in Non-obstructive coronary artery disease (n=243). Functional coronary microvascular dysfunction vs. Other CMD endotypes was evaluated on All-cause mortality at 5 years (p=<0.0001). Functional coronary microvascular dysfunction, defined as abnormal CFR (<2.5) with normal IMR (<25), was significantly associated with higher all-cause mortality at 5 years (log-rank P <0.0001).