Key result
Revascularisation linked to ~46% lower MACE risk in patients with impaired MFR.
Why the study?
Identifying patients with chronic coronary syndromes who may benefit from revascularization is complicated, and the role of myocardial flow reserve in this context is unclear.
Does cardiac revascularisation reduce MACE and all-cause mortality in patients with chronic coronary syndromes and reversible perfusion defects?
Population
1806 patients with chronic coronary syndromes and ≥5% reversible perfusion defects on 82Rb PET from Danish hospitals
Comparison
Revascularisation within 90 days vs no revascularisation within 90 days
Design
Multicentre registry cohort study
Follow-up
Median 37.0 months
Authors
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May support MFR-guided revascularisation in chronic coronary syndromes; hypothesis-generating and requires randomized confirmation.
Cohort (n=1,806)
Yes
Does cardiac revascularisation reduce MACE and all-cause mortality in patients with chronic coronary syndromes and reversible perfusion defects?
Hazard Ratio: 0.54 (95% CI 0.33–0.87)
p-value: p=0.012
Revascularization is associated with improved prognosis (lower mortality and MACE) in patients with chronic coronary syndromes and regional ischemia only if they have impaired myocardial flow reserve (MFR < 2).
Toftholm et al. (2024) conducted a cohort in chronic coronary syndromes (CCS) (n=1,806). Revascularisation vs. No revascularisation was evaluated on MACE in patients with MFR < 2 (HR 0.54, 95% CI 0.33-0.87, p=0.012). Revascularisation was associated with a lower risk of MACE (HR 0.54; 95% CI 0.33-0.87) and mortality in patients with impaired myocardial flow reserve (MFR < 2), but not in those with normal MFR.
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