Introduction
Methods
Patient selection
PET
CMR
ICA and FFR
Statistical analysis
Results
All patients n = 137 | No cardiac history n = 53 | Prior MI n = 41 | Prior non-MI PCI n = 43 | P value | |
---|---|---|---|---|---|
Characteristics | |||||
Male | 119 (87%) | 46 (87%) | 36 (88%) | 37 (86%) | 0.97 |
Age, years | 62.2 ± 9.5 | 58.7 ± 9.0 | 63.4 ± 8.3 | 65.5 ± 9.8 | < 0.01 |
BMI, kg/m2 | 27.0 ± 3.9 | 27.1 ± 3.9 | 26.5 ± 3.5 | 27.4 ± 4.4 | 0.56 |
LVEF (%) | n/a | Estimated > 50% | 56.6 (9.7) | 59.9 (9.2) | n/a |
Cardiovascular risk factors | |||||
Diabetes Mellitus | 29 (21%) | 7 (13%) | 12 (29%) | 10 (23%) | 0.19 |
Hypertension | 76 (56%) | 21 (40.0%) | 27 (66%) | 28 (65%) | 0.01 |
Hypercholesterolemia | 88 (64%) | 25 (47%) | 33 (81%) | 30 (70%) | < 0.01 |
History of smoking | 70 (51%) | 29 (54%) | 21 (51%) | 20 (47%) | 0.73 |
Family history of CAD | 66 (48%) | 26 (49%) | 20 (49%) | 20 (47%) | 0.97 |
Medication | |||||
Antiplatelet therapy | 135 (99%) | 51 (96%) | 41 (100%) | 43 (100%) | 0.20 |
Β-blocker | 90 (66%) | 41 (77%) | 24 (59%) | 25 (58%) | 0.07 |
Calcium channel blocker | 47 (34%) | 16 (30%) | 12 (29%) | 19 (44%) | 0.26 |
ACE-inhibitor | 38 (28%) | 12 (23%) | 12 (29%) | 14 (33%) | 0.54 |
ARB | 27 (20%) | 6 (11%) | 11 (27%) | 10 (23%) | 0.14 |
Statin | 112 (82.0%) | 42 (80%) | 35 (85%) | 35 (81%) | 0.75 |
Long acting nitrate | 25 (18%) | 5 (9%) | 8 (20%) | 12 (28%) | 0.06 |
Symptoms | |||||
Typical AP | 67 (49%) | 23 (43%) | 21 (51%) | 23 (54%) | 0.56 |
Atypical AP | 24 (18%) | 13 (25%) | 6 (15%) | 5 (11%) | 0.22 |
Non-specific chest discomfort | 46 (34%) | 17 (32%) | 14 (34%) | 15 (35%) | 0.96 |
Characteristics Total patients | All patients n = 137 | No cardiac history n = 53 | Prior MI n = 41 | Prior non-MI PCI n = 43 | P value |
---|---|---|---|---|---|
All vessels | n = 411 | n = 159 | N = 123 | N = 129 | |
Revascularized | 200 (49%) | 90 (57%) | 54 (44%) | 56 (43%) | 0.04 |
PCI | 149 (75%) | 47 (52%) | 46 (85%) | 56 (100%) | < 0.01 |
CABG | 51 (26%) | 43 (48%) | 8 (15%) | 0 (0%) | < 0.01 |
LGE (% of territory, n = 106) | n/a | n/a | 0.6 (0.0–13.0_ | 0.0 (0.0–0.63) | n/a |
Per vessel | |||||
LAD | |||||
Revascularized | 93 | 44 (83%) | 26 (63%) | 23 (53%) | < 0.01 |
PCI | 72 (78%) | 26 (59%) | 23 (89%) | 23 (100%) | < 0.01 |
CABG | 21 (23%) | 18 (41%) | 3 (12%) | 0 (0%) | < 0.01 |
LGE (% of territory, n = 44) | n/a | n/a | 0.0(0.0 –10.7) | 0.0 (0.0–0.1) | |
RCX | |||||
Revascularized | 56 | 23 (43%) | 12 (29%) | 21 (49%) | 0.17 |
PCI | 40 (71%) | 10 (44%) | 9 (75%) | 21 (100%) | < 0.01 |
CABG | 16 (29%) | 13 (57%) | 3 (25%) | 0 (0%) | < 0.01 |
LGE (% of territory, n = 31) | n/a | n/a | 4.4 (0.2 – 27.8) | 0.0 (0.0–3.1) | n/a |
RCA | |||||
Revascularized | 51 | 23 (43%) | 16 (39% | 12 (28%) | 0.28 |
PCI | 37 (73%) | 11 (48%) | 14 (88%) | 12 (100%) | < 0.01 |
CABG | 14 (28.5%) | 12 (52%) | 2 (13%) | 0 (0%) | < 0.01 |
LGE (% of territory, n = 28) | n/a | n/a | 1.0 (0.0–14.4) | 0.0 (0.0–1.4) | n/a |
Before revascularization | After revascularization | % change | P value before—after | |
---|---|---|---|---|
Rest MBF | ||||
No prior CAD | 0.77 ± 0.16 | 0.86 ± 025 | 11.69 | < 0.01 |
Prior MI | 090 ± 0.22 | 0.89 ± 0.21 | -1.11 | 0.88 |
Prior non-MI PCI | 0.91 ± 0.24 | 0.91 ± 0.22 | 0.00 | 0.95 |
P value between groups | < 0.01 | 0.36 | ||
Hyperemic MBF | ||||
No prior CAD | 1.53 ± 0.54 | 2.44 ± 0.89 | 59.48 | < 0.01 |
Prior MI | 1.86 ± 0.85 | 2.40 ± 0.88 | 29.03 | < 0.01 |
Prior non-MI PCI | 1.90 ± 0.86 | 2.55 ± 0.85 | 34.21 | < 0.01 |
P value between groups | < 0.01 | 0.68 | ||
CFR | ||||
No prior CAD | 2.02 ± 0.69 | 2.92 ± 0.95 | 44.55 | < 0.01 |
Prior MI | 2.11 ± 0.89 | 2.73 ± 0.98 | 29.38 | < 0.01 |
Prior non-MI PCI | 2.15 ± 0.90 | 2.85 ± 0.97 | 32.56 | < 0.01 |
P value between groups | 0.61 | 0.49 | ||
FFR | ||||
No prior CAD | 0.58 ± 0.19 | 0.89 ± 0.08 | 53.44 | < 0.01 |
Prior MI | 0.67 ± 0.12 | 0.90 ± 0.07 | 34.33 | < 0.01 |
Prior non-MI PCI | 0.71 ± 0.10 | 0.91 ± 0.07 | 28.17 | < 0.01 |
P value between groups | < 0.01 | 0.39 |