Key result
High resting coronary flow velocity linked to ~370% greater risk of death, MI, or ACS.
Why the study?
Information was lacking regarding the prognostic value of high coronary artery velocity measured during echocardiography.
Does high baseline coronary flow velocity during resting echocardiography predict major adverse cardiac events in patients referred for echocardiography?
Cohort (n=747)
Does high baseline coronary flow velocity during resting echocardiography predict major adverse cardiac events in patients referred for echocardiography?
High baseline coronary flow velocity (>65 cm/s) in proximal segments during resting echocardiography provides significant additive prognostic value to ejection fraction for predicting major adverse cardiac events.
High resting proximal coronary flow velocity may aid risk stratification beyond EF; leaves open prospective validation before clinical adoption.
Background There is a lack of information about the prognostic value of high velocity in coronary arteries during echocardiography. The present study was aimed at investigating the three-year prognostic value of coronary velocity assessment in all patients who were referred for echocardiography examination.Methods The prospective study comprises 747 consecutive patients. Death, myocardial infarction (MI), acute coronary syndrome (ACS), and/or revascularisation were defined as major adverse cardiac events (MACE). Routine echocardiography was added with coronary velocity assessment in the left main, anterior descending, or circumflex coronary arteries by the Doppler method.Results During a median follow-up of 36 months, 192 patients experienced MACE. Deaths occurred more frequently in patients with high local velocity in proximal left-sided segments vs. in middle left-sided segments vs. patients without high coronary velocity (9 vs. 3 vs. 1%, p < 0.0001). Death/MI/ACS occurred in 17 vs. 7 vs. 1%, p < 0.0001, respectively. Age (HR 1.04, 95% CI 1.00; 1.06; p < 0.04), a velocity more than 65 cm/s in any proximal segments of the arteries (HR 4.7, 95% CI 1.9; 11.9; p < 0.002), ejection fraction (HR 0.97, 95% CI 0.94; 0.99; p < 0.007) were strong independent prognostic predictors of death/MI/ACS. The maximal velocity of coronary flow velocity had a significant additive prognostic value to ejection fraction.Conclusions The coronary velocity parameters give long-term prognostic information that can be used to identify persons with a high risk of MACE in consecutive non-selected patients.
No takes yet. Share an insight, caveat, or question.
Zagatina et al. (2022) conducted a cohort in Patients referred for echocardiography (n=747). High coronary flow velocity (>65 cm/s) vs. No high coronary velocity was evaluated on Death, myocardial infarction, or acute coronary syndrome (HR 4.7, 95% CI 1.9-11.9, p=<0.002). High coronary flow velocity (>65 cm/s) in proximal segments during resting echocardiography independently predicted death, MI, or ACS (HR 4.7; 95% CI 1.9-11.9; p<0.002).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: