10.6084/M9.FIGSHARE.C.6272897.V1
Wen Zhang
Wen
Zhang
Tongji University
Shekhar Singh
Shekhar
Singh
Tongji University
Lu Liu
Lu
Liu
Tongji University
Abdul-Quddus Mohammed
Abdul-Quddus
Mohammed
Tongji University
Guoqing Yin
Guoqing
Yin
Tongji University
Siling Xu
Siling
Xu
Tongji University
Xian Lv
Xian
Lv
Tongji University
Tingting Shi
Tingting
Shi
Tongji University
Cailin Feng
Cailin
Feng
Tongji University
Rong Jiang
Rong
Jiang
Tongji University
Ayman A. Mohammed
Ayman A.
Mohammed
Tongji University
Redhwan M. Mareai
Redhwan M.
Mareai
Tongji University
Yawei Xu
Yawei
Xu
Tongji University
Xuejing Yu
Xuejing
Yu
Tongji University
Shanghai Tenth People's Hospital
Fuad A. Abdu
Fuad A.
Abdu
Tongji University
Wenliang Che
Wenliang
Che
Tongji University
Shanghai Tenth People's Hospital
Prognostic value of coronary microvascular dysfunction assessed by coronary angiography-derived index of microcirculatory resistance in diabetic patients with chronic coronary syndrome
Abstract Background Coronary microvascular dysfunction (CMD) is common and is associated with unfavorable cardiovascular events in patients with diabetes mellitus (DM). Coronary angiography-derived index of microcirculatory resistance (caIMR) is a recently developed wire- and hyperemic agent-free method to assess CMD. We aimed to investigate the prognostic impact of CMD assessed by caIMR on clinical outcomes in patients with DM and chronic coronary syndrome (CCS). Methods CCS patients who underwent coronary angiography between June 2015 to May 2018 were included. Coronary microvascular function was measured by caIMR, and CMD was defined as caIMR ≥ 25U. The primary endpoint was major adverse cardiac events (MACE). Kaplan-Meier analysis and Cox proportional hazards models were used to assess the relationship between caIMR and the risk of MACE. Results Of 290 CCS patients, 102 patients had DM. Compared with non-diabetic patients, CMD (caIMR ≥ 25U) was higher among DM patients (57.8% vs. 38.3%; p = 0.001). During a mean 35 months follow-up, 40 MACE had occurred. Patients with caIMR ≥ 25 had a higher rate of MACE than patients with caIMR < 25 (20.6% vs. 8.2%, p = 0.002). Of these, the MACE rate was higher among DM patients with caIMR ≥ 25 than those with caIMR < 25 (33.9% vs. 14.0%; p = 0.022). In multivariable Cox analysis, caIMR ≥ 25 was independently associated with MACE in the DM patients but not in non-DM patients (HR, 2.760; 95% CI, 1.066–7.146; P = 0.036). Conclusion CMD assessed by caIMR was common and is an independent predictor of MACE among diabetic patients with CCS. This finding potentially enables a triage of higher-risk patients to more intensive therapy.
Medicine
Chemical Sciences not elsewhere classified
Immunology
Biological Sciences not elsewhere classified
Mathematical Sciences not elsewhere classified
Developmental Biology
Science Policy
Hematology
figshare
2022
2022-10-30
2022-10-30
Collection
10.6084/m9.figshare.c.6272897
CC BY 4.0