TY - JOUR
T1 - Coronary vascular dysfunction is associated with increased risk of death in patients with peripheral artery disease
AU - Peri-Okonny, Poghni A.
AU - Patel, Krishna K.
AU - Garcia, R. Angel
AU - Thomas, Merrill
AU - McGhie, A. Iain
AU - Bunte, Matthew C.
AU - Spertus, John A.
AU - Thompson, Randall C.
AU - Bateman, Timothy M.
N1 - Publisher Copyright:
© 2023, The Author(s) under exclusive licence to American Society of Nuclear Cardiology.
PY - 2023/12
Y1 - 2023/12
N2 - Background: Peripheral artery disease (PAD) and coronary vascular dysfunction are common in patients with cardiometabolic disease. Neither the prevalence of coronary vascular dysfunction among patients with PAD nor the prognostic impact with these two conditions present together has been well studied. Methods: Consecutive patients who underwent PET MPI were analyzed for presence of coronary vascular dysfunction [myocardial blood flow reserve (MBFR) < 2]. Cox regression was used to examine the association of reduced MBFR with mortality in patients with PAD, as well as the association of comorbid MBFR < 2 and PAD with all-cause death. Results: Among 13,940 patients, 1936 (14%) had PAD, 7782 (56%) had MBFR < 2 and 1346 (10%) had both PAD and MBFR < 2. Reduced MBFR was very common (69.5%) and was associated with increased risk of all-cause death (HR 1.69, 95%CI 1.32, 2.16, p < 0.01) in patients with PAD. Patients with both PAD and MBFR < 2, and those with either PAD or reduced MBFR had increased risk of death compared to those with neither condition: PAD + MBFR < 2 [(HR 95%CI), 2.30; 1.97–2.68], PAD + MBFR ≥ 2 (1.37; (1.08–1.72), PAD − MBFR < 2 (1.98; 1.75–2.25), p < 0.001 for all). Conclusion: Coronary vascular dysfunction was common in patients with PAD and was associated with increased risk of death.
AB - Background: Peripheral artery disease (PAD) and coronary vascular dysfunction are common in patients with cardiometabolic disease. Neither the prevalence of coronary vascular dysfunction among patients with PAD nor the prognostic impact with these two conditions present together has been well studied. Methods: Consecutive patients who underwent PET MPI were analyzed for presence of coronary vascular dysfunction [myocardial blood flow reserve (MBFR) < 2]. Cox regression was used to examine the association of reduced MBFR with mortality in patients with PAD, as well as the association of comorbid MBFR < 2 and PAD with all-cause death. Results: Among 13,940 patients, 1936 (14%) had PAD, 7782 (56%) had MBFR < 2 and 1346 (10%) had both PAD and MBFR < 2. Reduced MBFR was very common (69.5%) and was associated with increased risk of all-cause death (HR 1.69, 95%CI 1.32, 2.16, p < 0.01) in patients with PAD. Patients with both PAD and MBFR < 2, and those with either PAD or reduced MBFR had increased risk of death compared to those with neither condition: PAD + MBFR < 2 [(HR 95%CI), 2.30; 1.97–2.68], PAD + MBFR ≥ 2 (1.37; (1.08–1.72), PAD − MBFR < 2 (1.98; 1.75–2.25), p < 0.001 for all). Conclusion: Coronary vascular dysfunction was common in patients with PAD and was associated with increased risk of death.
KW - Coronary artery disease
KW - Coronary microvascular dysfunction
KW - Myocardial blood flow reserve
KW - Peripheral artery disease
UR - https://www.scopus.com/pages/publications/85166305986
U2 - 10.1007/s12350-023-03343-y
DO - 10.1007/s12350-023-03343-y
M3 - Article
C2 - 37524997
AN - SCOPUS:85166305986
SN - 1071-3581
VL - 30
SP - 2666
EP - 2675
JO - Journal of Nuclear Cardiology
JF - Journal of Nuclear Cardiology
IS - 6
ER -