Key result
Male sex and diabetes linked to lower stress myocardial perfusion independent of coronary stenosis.
Why the study?
Diagnosis and treatment of suspected CCS rely on coronary artery stenosis and its impact on myocardial perfusion, but perfusion can be affected by other factors.
Do sex, age, diabetes, hypertension, and smoking affect quantitative myocardial perfusion independent of coronary artery stenosis in patients with suspected or established chronic coronary syndrome?
Observational (n=86)
Do sex, age, diabetes, hypertension, and smoking affect quantitative myocardial perfusion independent of coronary artery stenosis in patients with suspected or established chronic coronary syndrome?
Sex, age, diabetes, hypertension, and smoking affect myocardial perfusion independent of coronary artery stenosis, highlighting the need to consider these factors when interpreting quantitative myocardial perfusion in patients with suspected or established CCS.
May require adjusted perfusion thresholds by sex and diabetes; leaves open prognostic implications in chronic coronary syndrome.
Diagnosis and treatment of patients with suspected chronic coronary syndrome (CCS) currently relies on the degree of coronary artery stenosis and its significance for myocardial perfusion. However, myocardial perfusion can be affected by factors other than coronary stenosis. The aim of this study was to investigate to what extent sex, age, diabetes, hypertension and smoking affect quantitative myocardial perfusion, beyond the degree of coronary artery stenosis, in patients with suspected or established CCS. Eighty‐six patients [median age 69 (range 46−86) years, 24 females] planned for elective coronary angiography due to suspected or established CCS were included. All patients underwent cardiac 13 N‐NH 3 positron emission tomography to quantify myocardial perfusion at rest and stress. Lowest myocardial perfusion (perfusion min ) at stress and rest and lowest myocardial perfusion reserve (MPR min ) for all vessel territories was used as dependent variables in a linear mixed model. Independent variables were vessel territory, degree of coronary artery stenosis (as a continuous variable of 0%−100% stenosis), sex, age, diabetes, hypertension and smoking habits. Degree of coronary artery stenosis ( p < 0.001), male sex (1.8 ± 0.6 vs. 2.3 ± 0.6 mL/min/g, p < 0.001), increasing age ( p = 0.025), diabetes (1.6 ± 0.5 vs. 2.0 ± 0.6 mL/min/g, p = 0.023) and smoking (1.9 ± 0.6 vs. 2.1 ± 0.6 mL/min/g, p = 0.052) were independently associated with myocardial perfusion min at stress. Degree of coronary artery stenosis ( p < 0.001), age ( p = 0.040), diabetes (1.8 ± 0.6 vs. 2.3 ± 0.7, p = 0.046) and hypertension (2.2 ± 0.7 vs. 2.5 ± 0.6, p = 0.033) were independently associated with MPR min . Sex, increasing age, diabetes, hypertension and smoking affect myocardial perfusion independent of coronary artery stenosis in patients with suspected or established CCS. Thus, these factors need to be considered when assessing the significance of reduced quantitative myocardial perfusion of patients with suspected or established CCS.
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Székely et al. (2023) conducted an observational in suspected or established chronic coronary syndrome (n=86). Risk factors (sex, age, diabetes, hypertension, smoking) was evaluated on Lowest myocardial perfusion at stress and rest and lowest myocardial perfusion reserve. Male sex (1.8 vs 2.3 mL/min/g, p<0.001) and diabetes (1.6 vs 2.0 mL/min/g, p=0.023) were independently associated with lower stress myocardial perfusion, beyond the degree of coronary stenosis.
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