Key result
Coronary microvascular dysfunction (caIMR ≥ 25U) was independently associated with a increased risk of major adverse cardiac events in diabetic patients with chronic coronary syndrome.
Why the study?
Coronary microvascular dysfunction (CMD) is common and linked to adverse cardiovascular events in DM, but the prognostic impact of CMD assessed using the wire- and hyperemic agent-free caIMR in patients with DM and chronic coronary syndrome was uncharacterized.
Does coronary microvascular dysfunction assessed by caIMR predict major adverse cardiac events in diabetic patients with chronic coronary syndrome?
Cohort (n=290)
No
Does coronary microvascular dysfunction assessed by caIMR predict major adverse cardiac events in diabetic patients with chronic coronary syndrome?
Answers are grounded in this paper and cite their sources.
BACKGROUND: Coronary microvascular dysfunction (CMD) is common and is associated with unfavorable cardiovascular events in patients with diabetes mellitus (DM). Coronary angiography-derived index of microcirculatory resistance (caIMR) is a recently developed wire- and hyperemic agent-free method to assess CMD. We aimed to investigate the prognostic impact of CMD assessed by caIMR on clinical outcomes in patients with DM and chronic coronary syndrome (CCS). METHODS: CCS patients who underwent coronary angiography between June 2015 to May 2018 were included. Coronary microvascular function was measured by caIMR, and CMD was defined as caIMR ≥ 25U. The primary endpoint was major adverse cardiac events (MACE). Kaplan-Meier analysis and Cox proportional hazards models were used to assess the relationship between caIMR and the risk of MACE. RESULTS: Of 290 CCS patients, 102 patients had DM. Compared with non-diabetic patients, CMD (caIMR ≥ 25U) was higher among DM patients (57.8% vs. 38.3%; p = 0.001). During a mean 35 months follow-up, 40 MACE had occurred. Patients with caIMR ≥ 25 had a higher rate of MACE than patients with caIMR < 25 (20.6% vs. 8.2%, p = 0.002). Of these, the MACE rate was higher among DM patients with caIMR ≥ 25 than those with caIMR < 25 (33.9% vs. 14.0%; p = 0.022). In multivariable Cox analysis, caIMR ≥ 25 was independently associated with MACE in the DM patients but not in non-DM patients (HR, 2.760; 95% CI, 1.066-7.146; P = 0.036). CONCLUSION: CMD assessed by caIMR was common and is an independent predictor of MACE among diabetic patients with CCS. This finding potentially enables a triage of higher-risk patients to more intensive therapy.
No takes yet. Share an insight, caveat, or question.
Zhang et al. (2022) conducted a cohort in Chronic coronary syndrome (n=290). Coronary microvascular dysfunction (caIMR ≥ 25U) vs. Normal coronary microvascular function (caIMR < 25U) was evaluated on Major adverse cardiac events (MACE) (HR 2.760, 95% CI 1.066-7.146, p=0.036). Coronary microvascular dysfunction (caIMR ≥ 25U) was independently associated with a increased risk of major adverse cardiac events in diabetic patients with chronic coronary syndrome.
Synapse has enriched 10 related papers. Consider them for comparative context: