Page 81 - Coronary hemodynamics in acute myocardial infarction - Matthijs Bax

Table 1. Baseline Clinical Characteristics (n=94) Demographics
Age
Male Sex
Risk Factors for coronary artery disease
Smoking Hypertension Family History Hyperlipidemia Diabetes Mellitus
Prior medication use β-Blockers
Calcium antagonists Angiotensin-converting enzyme inhibitors Nitrates
Lipid lowering drugs
Aspirin
Data are presented as mean±SD or frequency (%)
56 ± 12 79 (84)
51 (54) 22 (23) 38 (40) 25 (27) 6 (6)
13 (14) 7 (7) 4 (4) 4 (4) 7 (7)
11 (12) 5
Coronary microvascular function and long-term mortality
During a median follow-up of 11.0 years (interquartile range, 10.0–12.1 years) 18% of patients died (17 of 94), whereas 16% (15 of 94) of patients died of a cardiac cause. The 10-year Kaplan–Meier estimate of cumulative all-cause mortality was 15%, and amounted to 14% for cardiac mortality.
Flow Velocity Parameters and Long-term Cardiac Mortality
The optimal identified cut-off values were 2.1 for CFVR in the reference vessel (sensitivity 73%, specificity 71%), and 1.5 for CFVR in the infarct-related artery (sensitivity 73%, specificity 62%).
Ten-year estimates of cardiac mortality differed significantly between high and low reference vessel CFVR groups, and amounted to 5% in patients with high reference vessel CFVR values, compared with 31% in patients with low reference vessel CFVR values (P=0.001; Figure A). In contrast, 10-year estimates of cardiac mortality amounted to 9% and 20% in patients with high and low infarct-related artery CFVR values, respectively, which was not significantly different between groups (P=0.10; Figure B). In bivariate analysis, a reference vessel CFVR of <2.1 was associated with a 3.67-fold increase in long-term cardiac mortality hazard (hazard ratio [HR], 3.67; 95% confidence interval, 1.19–11.37; P=0.02; Table 2). Contrariwise, a target vessel CFVR of <1.5 was not associated with an increase in long-term cardiac mortality hazard (HR, 1.67; 95% confidence interval, 0.56– 4.98; P=0.36). There was no significant difference in cardiac mortality rates
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