Integrated Noninvasive Physiological Assessment of Coronary Circulatory Function and Impact on Cardiovascular Mortality in Patients With Stable Coronary Artery Disease
Key result
CFR outperforms MBF in predicting cardiovascular mortality, and integrating both identifies unique CAD prognostic phenotypes.
Why the study?
The prognostic value of integrating coronary flow reserve and maximal myocardial blood flow for cardiovascular mortality in stable coronary artery disease patients was unclear.
Does the integration of coronary flow reserve (CFR) and maximal myocardial blood flow (MBF) predict cardiovascular mortality in patients with stable coronary artery disease?
Key Points
- To determine the comparative and integrated prognostic value of coronary flow reserve and maximal myocardial blood flow for predicting cardiovascular mortality in patients with stable coronary artery disease.
- Assessed coronary circulatory function noninvasively by measuring coronary flow reserve (CFR) and maximal myocardial blood flow (MBF) in patients with known or suspected coronary artery disease.
- Classified patients into concordant and discordant physiological categories by integrating CFR and maximal MBF measurements to evaluate prognostic phenotypes.
- Coronary flow reserve served as a stronger predictor of cardiovascular mortality than maximal myocardial blood flow.
- Integrated concordant and discordant categories of CFR and maximal MBF successfully identified unique prognostic risk phenotypes in patients with coronary artery disease.
Structured PICO
Does the integration of coronary flow reserve (CFR) and maximal myocardial blood flow (MBF) predict cardiovascular mortality in patients with stable coronary artery disease?
P
Population
Patients with known or suspected stable coronary artery disease
I
Intervention
Integrated noninvasive physiological assessment of coronary circulatory function (coronary flow reserve [CFR] and maximal myocardial blood flow [MBF])
O
Outcome
Cardiovascular mortalityhard clinical
Integrating coronary flow reserve and maximal myocardial blood flow provides unique prognostic phenotypes for predicting cardiovascular mortality in patients with stable coronary artery disease.
Authors
Discussion
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Implication
May refine risk stratification in stable CAD; hypothesis-generating and requires prospective validation before practice change.
Cite This Study
Gupta et al. (2017) studied this question. Coronary flow reserve (CFR) is a stronger predictor of cardiovascular mortality than maximal myocardial blood flow (MBF), and integrating both identifies unique prognostic phenotypes in CAD.