Adverse cardiovascular events in patients with coronary microvascular dysfunction: results of a 12-month follow-up with a control group
Aim. To assess the development of adverse cardiovascular events in patients with non-obstructive coronary artery disease (CAD) and coronary microvascular dysfunction (CMD), identified by dynamic myocardial single-photon emission computed tomography (SPECT), during 12-month follow-up compared with pa...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
«FIRMA «SILICEA» LLC
2023-04-01
|
| Series: | Российский кардиологический журнал |
| Subjects: | |
| Online Access: | https://russjcardiol.elpub.ru/jour/article/view/5269 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1839576547139256320 |
|---|---|
| author | K. V. Kopyeva A. N. Maltseva A. V. Mochula E. V. Grakova K. V. Zavadovsky |
| author_facet | K. V. Kopyeva A. N. Maltseva A. V. Mochula E. V. Grakova K. V. Zavadovsky |
| author_sort | K. V. Kopyeva |
| collection | DOAJ |
| description | Aim. To assess the development of adverse cardiovascular events in patients with non-obstructive coronary artery disease (CAD) and coronary microvascular dysfunction (CMD), identified by dynamic myocardial single-photon emission computed tomography (SPECT), during 12-month follow-up compared with patients without CMD.Material and methods. The study included 118 patients (70 men, mean age, 62,0 [58,0; 69,0] years) with preserved ejection fraction (62 [59; 64] %) and non-obstructive CAD. Serum levels of the N-terminal pro-brain natriuretic peptide were assessed at baseline by enzyme immunoassay. Coronary flow reserve (CFR) was assessed by dynamic SPECT. CFR ≤2 was a CMD marker.Results. Six patients discontinued participation in the study due to loss of contact with them, while the rest were divided into groups depending on CMD presence: group 1 included patients with CMD (CFR ≤2; n=42), and group 2 was the control group and included patients without CMD (CFR >2; n=70). Within 12-month follow-up, 25 patients reported adverse events. According to Kaplan-Meier analysis, the prevalence of adverse cardiovascular events was higher in patients with CMD (45,2%, n=19) than in patients without it (8,6%, n=6) (p<0,001). Multivariate regression analysis showed that the presence of CMD (odds ratio (OR), 2,42; 95% confidence interval (CI), 1,26-5,85; p<0,001) and diastolic dysfunction (OR, 3,27; 95% CI, 2,26-5,64; p<0,001) were independent predictors of poor outcomes. The combination of CMD with diastolic dysfunction more than 5 times increased the risk of adverse events (OR, 5,18; 95% CI, 3,61-11,84; p<0,001).Conclusion. We found that in patients with non-obstructive CAD, the presence of CMD, identified by dynamic myocardial SPECT, was associated with a higher risk of adverse cardiovascular events within 12-month follow-up period than in patients without CMD. At the same time, the combination of CMD with diastolic dysfunction more than 5 times increased the risk of adverse outcomes. |
| format | Article |
| id | doaj-art-a27fa0646539401683cf9fde9af3a8e3 |
| institution | Matheson Library |
| issn | 1560-4071 2618-7620 |
| language | Russian |
| publishDate | 2023-04-01 |
| publisher | «FIRMA «SILICEA» LLC |
| record_format | Article |
| series | Российский кардиологический журнал |
| spelling | doaj-art-a27fa0646539401683cf9fde9af3a8e32025-08-04T13:00:30Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202023-04-0128310.15829/1560-4071-2023-52693780Adverse cardiovascular events in patients with coronary microvascular dysfunction: results of a 12-month follow-up with a control groupK. V. Kopyeva0A. N. Maltseva1A. V. Mochula2E. V. Grakova3K. V. Zavadovsky4Cardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterCardiology Research Institute, Tomsk National Research Medical CenterAim. To assess the development of adverse cardiovascular events in patients with non-obstructive coronary artery disease (CAD) and coronary microvascular dysfunction (CMD), identified by dynamic myocardial single-photon emission computed tomography (SPECT), during 12-month follow-up compared with patients without CMD.Material and methods. The study included 118 patients (70 men, mean age, 62,0 [58,0; 69,0] years) with preserved ejection fraction (62 [59; 64] %) and non-obstructive CAD. Serum levels of the N-terminal pro-brain natriuretic peptide were assessed at baseline by enzyme immunoassay. Coronary flow reserve (CFR) was assessed by dynamic SPECT. CFR ≤2 was a CMD marker.Results. Six patients discontinued participation in the study due to loss of contact with them, while the rest were divided into groups depending on CMD presence: group 1 included patients with CMD (CFR ≤2; n=42), and group 2 was the control group and included patients without CMD (CFR >2; n=70). Within 12-month follow-up, 25 patients reported adverse events. According to Kaplan-Meier analysis, the prevalence of adverse cardiovascular events was higher in patients with CMD (45,2%, n=19) than in patients without it (8,6%, n=6) (p<0,001). Multivariate regression analysis showed that the presence of CMD (odds ratio (OR), 2,42; 95% confidence interval (CI), 1,26-5,85; p<0,001) and diastolic dysfunction (OR, 3,27; 95% CI, 2,26-5,64; p<0,001) were independent predictors of poor outcomes. The combination of CMD with diastolic dysfunction more than 5 times increased the risk of adverse events (OR, 5,18; 95% CI, 3,61-11,84; p<0,001).Conclusion. We found that in patients with non-obstructive CAD, the presence of CMD, identified by dynamic myocardial SPECT, was associated with a higher risk of adverse cardiovascular events within 12-month follow-up period than in patients without CMD. At the same time, the combination of CMD with diastolic dysfunction more than 5 times increased the risk of adverse outcomes.https://russjcardiol.elpub.ru/jour/article/view/5269heart failurepreserved ejection fractioncoronary microvascular dysfunctionprognosiscoronary blood flow reserve |
| spellingShingle | K. V. Kopyeva A. N. Maltseva A. V. Mochula E. V. Grakova K. V. Zavadovsky Adverse cardiovascular events in patients with coronary microvascular dysfunction: results of a 12-month follow-up with a control group Российский кардиологический журнал heart failure preserved ejection fraction coronary microvascular dysfunction prognosis coronary blood flow reserve |
| title | Adverse cardiovascular events in patients with coronary microvascular dysfunction: results of a 12-month follow-up with a control group |
| title_full | Adverse cardiovascular events in patients with coronary microvascular dysfunction: results of a 12-month follow-up with a control group |
| title_fullStr | Adverse cardiovascular events in patients with coronary microvascular dysfunction: results of a 12-month follow-up with a control group |
| title_full_unstemmed | Adverse cardiovascular events in patients with coronary microvascular dysfunction: results of a 12-month follow-up with a control group |
| title_short | Adverse cardiovascular events in patients with coronary microvascular dysfunction: results of a 12-month follow-up with a control group |
| title_sort | adverse cardiovascular events in patients with coronary microvascular dysfunction results of a 12 month follow up with a control group |
| topic | heart failure preserved ejection fraction coronary microvascular dysfunction prognosis coronary blood flow reserve |
| url | https://russjcardiol.elpub.ru/jour/article/view/5269 |
| work_keys_str_mv | AT kvkopyeva adversecardiovasculareventsinpatientswithcoronarymicrovasculardysfunctionresultsofa12monthfollowupwithacontrolgroup AT anmaltseva adversecardiovasculareventsinpatientswithcoronarymicrovasculardysfunctionresultsofa12monthfollowupwithacontrolgroup AT avmochula adversecardiovasculareventsinpatientswithcoronarymicrovasculardysfunctionresultsofa12monthfollowupwithacontrolgroup AT evgrakova adversecardiovasculareventsinpatientswithcoronarymicrovasculardysfunctionresultsofa12monthfollowupwithacontrolgroup AT kvzavadovsky adversecardiovasculareventsinpatientswithcoronarymicrovasculardysfunctionresultsofa12monthfollowupwithacontrolgroup |