Background: We assessed the prognostic value of structural abnormalities and coronary vasodilator function in diabetic patients referred to a PET/CT for suspected coronary artery disease (CAD). Methods: We studied 451 diabetics and 451 nondiabetics without overt CAD and normal myocardial perfusion. Myocardial blood flow (MBF) was computed from the dynamic rest and stress imaging. Myocardial flow reserve (MFR) was defined as ratio of hyperemic to baseline MBF and was considered reduced when < 2. Results: During a mean follow-up of 44 months 33 events occurred. Annualized event rate (AER) was higher in diabetic than nondiabetic patients (1.4% vs 0.3%, P < .001). Diabetic patients with reduced MFR had higher AER compared to those with preserved MFR (3.3% vs 0.4%, P < .001). At Cox analysis, age, BMI and reduced MFR were independent predictors of events in diabetic patients. Patients with diabetes and reduced MFR had lower event-free survival compared to nondiabetic patients and MFR < 2 (P < .001). Event-free survival was similar in patients with diabetes and normal MFR and those without diabetes and reduced MFR. Conclusions: Diabetic patients with reduced MFR had higher AER and lower event-free survival compared to those with preserved MFR and to nondiabetic patients.

Relation between myocardial blood flow and cardiac events in diabetic patients with suspected coronary artery disease and normal myocardial perfusion imaging / Assante, Roberta; Mainolfi, Ciro Gabriele; Zampella, Emilia; Gaudieri, Valeria; Nappi, Carmela; Mannarino, Teresa; D'Antonio, Adriana; Arumugam, Parthiban; Petretta, Mario; Cuocolo, Alberto; Acampa, Wanda. - In: JOURNAL OF NUCLEAR CARDIOLOGY. - ISSN 1071-3581. - 28:4(2021), pp. 1222-1233. [10.1007/s12350-021-02533-w]

Relation between myocardial blood flow and cardiac events in diabetic patients with suspected coronary artery disease and normal myocardial perfusion imaging

Assante, Roberta;Mainolfi, Ciro Gabriele;Zampella, Emilia;Gaudieri, Valeria;Nappi, Carmela;Mannarino, Teresa;D'Antonio, Adriana;Petretta, Mario;Cuocolo, Alberto;Acampa, Wanda
2021

Abstract

Background: We assessed the prognostic value of structural abnormalities and coronary vasodilator function in diabetic patients referred to a PET/CT for suspected coronary artery disease (CAD). Methods: We studied 451 diabetics and 451 nondiabetics without overt CAD and normal myocardial perfusion. Myocardial blood flow (MBF) was computed from the dynamic rest and stress imaging. Myocardial flow reserve (MFR) was defined as ratio of hyperemic to baseline MBF and was considered reduced when < 2. Results: During a mean follow-up of 44 months 33 events occurred. Annualized event rate (AER) was higher in diabetic than nondiabetic patients (1.4% vs 0.3%, P < .001). Diabetic patients with reduced MFR had higher AER compared to those with preserved MFR (3.3% vs 0.4%, P < .001). At Cox analysis, age, BMI and reduced MFR were independent predictors of events in diabetic patients. Patients with diabetes and reduced MFR had lower event-free survival compared to nondiabetic patients and MFR < 2 (P < .001). Event-free survival was similar in patients with diabetes and normal MFR and those without diabetes and reduced MFR. Conclusions: Diabetic patients with reduced MFR had higher AER and lower event-free survival compared to those with preserved MFR and to nondiabetic patients.
2021
Relation between myocardial blood flow and cardiac events in diabetic patients with suspected coronary artery disease and normal myocardial perfusion imaging / Assante, Roberta; Mainolfi, Ciro Gabriele; Zampella, Emilia; Gaudieri, Valeria; Nappi, Carmela; Mannarino, Teresa; D'Antonio, Adriana; Arumugam, Parthiban; Petretta, Mario; Cuocolo, Alberto; Acampa, Wanda. - In: JOURNAL OF NUCLEAR CARDIOLOGY. - ISSN 1071-3581. - 28:4(2021), pp. 1222-1233. [10.1007/s12350-021-02533-w]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/838989
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