Elevating cardiovascular prognostics: the role of peak filling rate in chronic coronary syndromes

Introduction Chronic coronary syndromes (CCS) are a significant contributor to cardiovascular morbidity and mortality. Early detection of myocardial dysfunction is crucial for improving outcomes. Peak Filling Rate (PFR), a diastolic function parameter derived from gated myocardial perfusion scintigraphy (MPS), has emerged as a potential prognostic marker for cardiovascular events in CCS patients. Method This retrospective cohort study analyzed 101 CCS patients who underwent gated MPS using Tc-99m sestamibi between January 2017 and June 2018. Patients were categorized based on PFR values (<2.1 vs. ≥2.1). The primary endpoint was major adverse cardiovascular events (MACE), including myocardial infarction, heart failure hospitalization, stroke, and cardiovascular death, over a one-year follow-up. Statistical analyses included Kaplan-Meier survival and Cox regression models. Results Patients with PFR <2.1 had a significantly higher incidence of MACE compared to those with PFR ≥2.1 (28.7% vs. 13.4%; p = 0.012). Survival analysis revealed reduced event-free survival in the PFR <2.1 group (mean survival: 8.87 vs. 11.70 months; log rank = 0.012). Multivariate analysis confirmed PFR <2.1 as an independent predictor of MACE (HR: 8.21; 95% CI: 1.11–60.43; p = 0.035). Conclusion Lower PFR values are associated with a higher risk of adverse cardiovascular events in CCS patients. Incorporating PFR assessment into routine clinical practice may enhance risk stratification and inform management strategies for better patient outcomes.