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Cited by 549

The DOI matches its Crossref record; 36 of the 36 references it cites were found in a registry or an index.

Association Between Coronary Vascular Dysfunction and Cardiac Mortality in Patients With and Without Diabetes Mellitus

Open access
Murthy, Venkatesh L., Naya, Masanao, Foster, Courtney R., Gaber, Mariya, Hainer, Jon, Klein, Josh, Dorbala, Sharmila, Blankstein, Ron, Di Carli, Marcelo F.·2012·Circulation
DOI 10.1161/circulationaha.112.120402
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Abstract

Background—: Diabetes mellitus increases the risk of adverse cardiac outcomes and is considered a coronary artery disease (CAD) equivalent. We examined whether coronary vascular dysfunction, an early manifestation of CAD, accounts for increased risk among diabetics compared with nondiabetics. Methods and Results—: A total of 2783 consecutive patients (1172 diabetics and 1611 nondiabetics) underwent quantification of coronary flow reserve (CFR; CFR=stress divided by rest myocardial blood flow) by positron emission tomography and were followed up for a median of 1.4 years (quartile 1–3, 0.7–3.2 years). The primary end point was cardiac death. Impaired CFR (below the median) was associated with an adjusted 3.2- and 4.9-fold increase in the rate of cardiac death for diabetics and nondiabetics, respectively ( P =0.0004). Addition of CFR to clinical and imaging risk models improved risk discrimination for both diabetics and nondiabetics (c index, 0.77–0.79, P =0.04; 0.82–0.85, P =0.03, respectively). Diabetic patients without known CAD with impaired CFR experienced a rate of cardiac death comparable to that for nondiabetic patients with known CAD (2.8%/y versus 2.0%/y; P =0.33). Conversely, diabetics without known CAD and preserved CFR had very low annualized cardiac mortality, which was similar to patients without known CAD or diabetes mellitus and normal stress perfusion and systolic function (0.3%/y versus 0.5%/y; P =0.65). Conclusions—: Coronary vasodilator dysfunction is a powerful, independent correlate of cardiac mortality among both diabetics and nondiabetics and provides meaningful incremental risk stratification. Among diabetic patients without CAD, those with impaired CFR have event rates comparable to those of patients with prior CAD, whereas those with preserved CFR have event rates comparable to those of nondiabetics.

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Metadata

Authors
Murthy, V. L., Naya, M., Foster, C. R., Gaber, M., Hainer, J., Klein, J., Dorbala, S., Blankstein, R., & Di Carli, M. F.
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2012-10-09
Volume
126
Issue
15
Pages
1858-1868
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/circulationaha.112.120402
OpenAlex
W1992822412
Cited by
549
References
36
FWCI
26.48
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: Association Between Coronary Vascular Dysfunction and Cardiac Mortality in Patients With and Without Diabetes Mellitus. https://app.cochat.ai/papers/10.1161/circulationaha.112.120402
The paper
Murthy, V. L., Naya, M., Foster, C. R., Gaber, M., Hainer, J., Klein, J., Dorbala, S., Blankstein, R., & Di Carli, M. F. (2012). Association Between Coronary Vascular Dysfunction and Cardiac Mortality in Patients With and Without Diabetes Mellitus. Circulation. https://doi.org/10.1161/circulationaha.112.120402

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.