D'Antonio, Adriana (2023) Prognostic value of modified coronary flow capacity by rubidium-82 PET/CT in patients with suspected CAD and normal myocardial perfusion imaging. [Tesi di dottorato]
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| Tipologia del documento: | Tesi di dottorato |
|---|---|
| Lingua: | English |
| Titolo: | Prognostic value of modified coronary flow capacity by rubidium-82 PET/CT in patients with suspected CAD and normal myocardial perfusion imaging |
| Autori: | Autore Email D'Antonio, Adriana a.dantonio62@gmail.com |
| Data: | 6 Dicembre 2023 |
| Numero di pagine: | 27 |
| Istituzione: | Università degli Studi di Napoli Federico II |
| Dipartimento: | Scienze Biomediche Avanzate |
| Dottorato: | Scienze biomorfologiche e chirurgiche |
| Ciclo di dottorato: | 36 |
| Coordinatore del Corso di dottorato: | nome email Cuocolo, Alberto cuocolo@unina.it |
| Tutor: | nome email Acampa, Wanda [non definito] |
| Data: | 6 Dicembre 2023 |
| Numero di pagine: | 27 |
| Parole chiave: | coronary flow capacity, myocardial perfusion imaging, cardiac PET/CT, coronary artery disease |
| Settori scientifico-disciplinari del MIUR: | Area 06 - Scienze mediche > MED/36 - Diagnostica per immagini e radioterapia |
| Depositato il: | 20 Dic 2023 16:34 |
| Ultima modifica: | 09 Mar 2026 13:52 |
| URI: | http://www.fedoa.unina.it/id/eprint/15692 |
Abstract
Background. The purpose of this study was to assess the prognostic value of modified coronary flow capacity (mCFC) in patients with suspected CAD and normal myocardial perfusion imaging (MPI) at cardiac 82Rb positron emission tomography (PET)/computed tomography (CT) imaging. Methods. We evaluated 4560 patients without previous history of CAD who underwent stress/rest Rubidium-82 cardiac PET/CT. Patients without previous history of CAD and normal MPI (n=2053) were included. Six CFC categories were obtained according to myocardial blood flow (MBF) and myocardial flow reserve (MFR) results. The mCFC was defined as impaired in patients “mildly reduced” or worse coronary flow in at least one coronary territory. End- points were defined as cardiovascular death, nonfatal myocardial infarction, unplanned hospitalization for any cardiac reasons, and unplanned coronary revascularization. Results. Follow-up was available in 1967 (96%) patients (median age 59±13 years). During a median time of 41 months (range 3-365), 72 events occurred (4% cumulative event rate, AER of 0.7% person-year). At multivariable COX analysis, age, diabetes, MFR < 2 and impaired mCFC (p < .001) resulted as independent predictors of events. In patients with reduced MFR, as well as in patients with normal MFR, the AER was significantly higher in patients with impaired mCFC as compared to those without (both p <.05). At Kaplan-Meier analysis the worse prognosis was observed in patients with impaired mCFC in both MFR groups. Conclusions. In patients with suspected CAD and normal MPI, impaired mCFC is associated with a higher risk of cardiac events. The mCFC may be useful to identify patients’ candidates to additional therapies in order to prevent future events.
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