long-term prognostic value of quantitative myocardial perfusion in patients with chest pain and normal coronary arteries

Patients with chest pain and no obstructive coronary artery disease have shown a high incidence of major adverse cardiovascular events (mace). we evaluated the role of absolute myocardial perfusion quantification in predicting all-cause mortality and mace during long-term follow-up in this group of patients. we studied 79 patients who underwent nitrogen-13 ammonia pet for quantification of global myocardial blood flow (mbf) and myocardial flow reserve (mfr) due to suspected impaired myocardial perfusion. patients with coronary artery disease (i.e., > 30% stenosis in one or more coronary arteries) were excluded. we assessed all-cause mortality and mace. mace was defined as the composite incidence of death, myocardial infarction (mi), or hospitalization due to heart failure. median follow-up was 8 (iqr: 3-14) years. univariate cox regression showed that only mfr (p = 0.01) was a predictor of all-cause mortality. univariate cox regression analysis showed that both mfr and stress mbf were predictors of the composite endpoint of mace (p < 0.001 and p = 0.01, respectively). quantitative assessment of myocardial perfusion predict all-cause mortality and mace in patients with chest pain and normal coronary arteries in the long-term follow-up.