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 me...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-022-01653-y |
| _version_ | 1811335390016045056 |
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| author | Wen Zhang Shekhar Singh Lu Liu Abdul-Quddus Mohammed Guoqing Yin Siling Xu Xian Lv Tingting Shi Cailin Feng Rong Jiang Ayman A. Mohammed Redhwan M. Mareai Yawei Xu Xuejing Yu Fuad A. Abdu Wenliang Che |
| author_facet | Wen Zhang Shekhar Singh Lu Liu Abdul-Quddus Mohammed Guoqing Yin Siling Xu Xian Lv Tingting Shi Cailin Feng Rong Jiang Ayman A. Mohammed Redhwan M. Mareai Yawei Xu Xuejing Yu Fuad A. Abdu Wenliang Che |
| author_sort | Wen Zhang |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-13T17:23:22Z |
| format | Article |
| id | doaj.art-aab40a38d90241e09231b580d69f1c95 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-04-13T17:23:22Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-aab40a38d90241e09231b580d69f1c952022-12-22T02:37:53ZengBMCCardiovascular Diabetology1475-28402022-10-0121111210.1186/s12933-022-01653-yPrognostic value of coronary microvascular dysfunction assessed by coronary angiography-derived index of microcirculatory resistance in diabetic patients with chronic coronary syndromeWen Zhang0Shekhar Singh1Lu Liu2Abdul-Quddus Mohammed3Guoqing Yin4Siling Xu5Xian Lv6Tingting Shi7Cailin Feng8Rong Jiang9Ayman A. Mohammed10Redhwan M. Mareai11Yawei Xu12Xuejing Yu13Fuad A. Abdu14Wenliang Che15Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineDepartment of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of MedicineAbstract 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.https://doi.org/10.1186/s12933-022-01653-yChronic coronary syndromeDiabetes mellitusCoronary microvascular dysfunctionCoronary angiography‑derived index of microvascular resistanceOutcome |
| spellingShingle | Wen Zhang Shekhar Singh Lu Liu Abdul-Quddus Mohammed Guoqing Yin Siling Xu Xian Lv Tingting Shi Cailin Feng Rong Jiang Ayman A. Mohammed Redhwan M. Mareai Yawei Xu Xuejing Yu Fuad A. Abdu Wenliang Che Prognostic value of coronary microvascular dysfunction assessed by coronary angiography-derived index of microcirculatory resistance in diabetic patients with chronic coronary syndrome Cardiovascular Diabetology Chronic coronary syndrome Diabetes mellitus Coronary microvascular dysfunction Coronary angiography‑derived index of microvascular resistance Outcome |
| title | Prognostic value of coronary microvascular dysfunction assessed by coronary angiography-derived index of microcirculatory resistance in diabetic patients with chronic coronary syndrome |
| title_full | Prognostic value of coronary microvascular dysfunction assessed by coronary angiography-derived index of microcirculatory resistance in diabetic patients with chronic coronary syndrome |
| title_fullStr | Prognostic value of coronary microvascular dysfunction assessed by coronary angiography-derived index of microcirculatory resistance in diabetic patients with chronic coronary syndrome |
| title_full_unstemmed | Prognostic value of coronary microvascular dysfunction assessed by coronary angiography-derived index of microcirculatory resistance in diabetic patients with chronic coronary syndrome |
| title_short | Prognostic value of coronary microvascular dysfunction assessed by coronary angiography-derived index of microcirculatory resistance in diabetic patients with chronic coronary syndrome |
| title_sort | prognostic value of coronary microvascular dysfunction assessed by coronary angiography derived index of microcirculatory resistance in diabetic patients with chronic coronary syndrome |
| topic | Chronic coronary syndrome Diabetes mellitus Coronary microvascular dysfunction Coronary angiography‑derived index of microvascular resistance Outcome |
| url | https://doi.org/10.1186/s12933-022-01653-y |
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