Evidence map›Paper›PMID 39983863›Full record

ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2025

Independent prognostic significance of myocardial flow reserve over coronary artery calcium, myocardial perfusion, and clinical variables in patients without known coronary artery disease, according to diabetes status.

Su Nam Lee, Pankaj Malhotra, Robert J H Miller, Heidi Gransar, Sean W Hayes, John D Friedman, Louise E J Thomson, Alan Rozanski, Piotr J Slomka, Donghee Han and 1 more

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Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Su Nam LeeMark Taper Imaging Center, Cedars Sinai Medical Center, Los Angeles, CA, USA; Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
Pankaj MalhotraMark Taper Imaging Center, Cedars Sinai Medical Center, Los Angeles, CA, USA; Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA.
Robert J H MillerDepartment of Cardiac Sciences, University of Calgary, 24 Ave NW, Calgary, AB, Canada.
Heidi GransarMark Taper Imaging Center, Cedars Sinai Medical Center, Los Angeles, CA, USA.
Sean W HayesMark Taper Imaging Center, Cedars Sinai Medical Center, Los Angeles, CA, USA.
John D FriedmanMark Taper Imaging Center, Cedars Sinai Medical Center, Los Angeles, CA, USA.
Louise E J ThomsonMark Taper Imaging Center, Cedars Sinai Medical Center, Los Angeles, CA, USA.
Alan RozanskiDivision of Cardiology, Mount Sinai St. Luke's Hospital, New York, NY, USA.
Piotr J SlomkaBiomedical Imaging Research Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA.
Donghee HanMark Taper Imaging Center, Cedars Sinai Medical Center, Los Angeles, CA, USA.
Daniel S BermanMark Taper Imaging Center, Cedars Sinai Medical Center, Los Angeles, CA, USA; Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: Daniel.Berman@cshs.org.

Funding

Patient-specific Outcome Prediction from Cardiovascular Multimodality Imaging by Artificial IntelligenceR35HL161195 · NHLBI · CEDARS-SINAI MEDICAL CENTER · PI Piotr J Slomka · 2022 to 2026
$5.0M
NHLBI NIH HHS R35 HL161195
6 · The paper itself

Abstract

objectiveTo explore differences in prevalence and prognosis associated with reduced myocardial flow reserve (MFR) in patients without known coronary artery disease (CAD) based on diabetes status.

methodsOf 2639 patients without known CAD who underwent rubidium positron emission tomography myocardial perfusion imaging (MPI), 818 patients (31%) had diabetes. Reduced MFR was defined as MFR <2.0. Coronary artery calcium (CAC) score was categorized as 0, 1-99, 100-399, and ≥400. Ischemic total perfusion deficit (TPD) was categorized as <1%, 1-<5%, and ≥5%. Outcome variables were all-cause death (ACD) and non-fatal myocardial infarction (MI).

resultsDuring the median follow-up of 4.1 years, 574 (21.8%) ACD/MI occurred (204 [25.1%] diabetic patients, 370 [20.3%] nondiabetic patients). In multivariable Cox analysis, reduced MFR was associated with increased ACD/MI in patients with diabetes (per .1 decrease: HR: 1.04, 95% CI: 1.02-1.06, P < .001) and patients without diabetes (per .1 decrease: HR: 1.03, 95% CI: 1.02-1.04, P < .001). No interaction existed between diabetes and MFR for ACD/MI risk regardless of CAC or ischemic burden (all P > .05). Adding MFR to the risk prediction model of clinical, conventional MPI findings, and CAC improved the discrimination for clinical outcomes in both groups (DM: .003, non-DM: <.001, respectively).

conclusionReduced MFR was more common in patients with diabetes and an important independent prognostic marker over CAC and clinical variables. The association between MFR and ACD/MI risk did not differ between patients with and without diabetes who had no prior CAD, regardless of CAC and ischemic burden.

Indexed as

CalciumCoronary Artery DiseaseCoronary VesselsDiabetes MellitusFractional Flow Reserve, MyocardialMyocardial Perfusion ImagingAgedFemaleHumansMaleMiddle AgedPositron-Emission TomographyPrognosisRetrospective StudiesRisk FactorsRubidium RadioisotopesCalciumRubidium RadioisotopesClinical outcomecoronary artery calciumDiabetesMyocardial flow reserveTotal perfusion deficit

Identifiers

PMID39983863
PMCPMC12094892

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.