Study on coronary flow reserve in the prognosis of elderly patients with coronary heart disease with adenosine triphosphate loaded myocardial perfusion imaging
Objective To analyze the predictive value of coronary flow reserve(CFR)in the occurrence of major ad-verse cardiovascular events(MACE)in elderly patients with coronary heart disease(CHD)during adenosine triphosphate(ATP)loaded myocardial perfusion imaging(MPI).Methods A retrospective analysis was conducted on the clinical data of 208 elderly CHD patients admitted to Huadong Hospital Affiliated to Fudan University from January 2019 to December 2021.They were divided into study group(n =71)and control group(n =137)according to whether MACE occurred.The age,gender,myocardial infarction,angina pectoris,hypertension,diabetes,smoking,β-blocker use,CFR,and myocardial ische-mia were compared between the two groups.The binary logistic regression method was used to analyze the influencing factors of MACE in elderly CHD patients,and the receiver operating characteristic(ROC)curve was used to analyze the value of CFR in predicting the prognosis of elderly CHD patients.Results Compared with the control group,the study group had higher constituent ratio of myocardial infarction,diabetes and myocardial ischemia,fewer users of β-blockers,and lower CFR,with statistical significance(P<0.05).Binary logistic regression showed that myocardial infarction and decreased CFR were risk factors for MACE in elderly CHD patients,and β-blocker use was a protective factor for MACE in elderly CHD patients.The ROC curve showed that the critical value of CFR was2.10,the area under the curve was0.799,the sensitivity was76.10% ,thespecificitywas27.00% ,and the Yoden index was0.491(P<0.05).Conclusion The decrease in CFR during ATP loaded MPI may have predictive value for the occurrence of MACE in elderly CHD patients.