New Imaging Combo Offers Hope for High-Risk Heart Patients
By HospiMedica International staff writers
Posted on 06 Feb 2026
Patients with type 2 diabetes often develop complex, severe coronary artery disease involving multiple narrowed or blocked arteries, making complete revascularization difficult. Without detailed functional assessment, blockages that appear mild on imaging but are clinically significant may be overlooked, increasing the risk of incomplete revascularization and persistent ischemia despite treatment. New research now indicates that combining an innovative angiography-based coronary imaging technology with the diabetes drug SGLT2 improves cardiovascular outcomes in this high-risk group.
Image: Professor Yiu Kai-hang (left), who led the research, and his team member Dr Xuan Haochen (Photo courtesy of HKUMed)
To address this challenge, a research team led by Hong Kong’s LKS Faculty of Medicine (HKUMed), in collaboration with the University of Hong Kong–Shenzhen Hospital, evaluated the caFFR system, an innovative imaging technology that enables accurate measurement of coronary blood flow from standard angiogram images. By allowing cardiologists to identify which arterial blockages are truly responsible for ischemia, the approach supports more precise clinical decision-making and the development of more effective interventional treatment strategies for high-risk patients.
The research team analyzed data from 671 patients with type 2 diabetes mellitus (T2DM) and coronary artery disease who underwent angiogram imaging in public hospitals between 2014 and 2016. While some patients achieved complete revascularization, many had residual stenosis after intervention due to diffuse and complex diabetic atherosclerosis. Notably, among those with incomplete revascularization, use of sodium–glucose cotransporter 2 inhibitors (SGLT2) provided strong vascular protection. Over three years, the incidence of major adverse cardiovascular events fell from 17.8% to 8.3%, and all‑cause mortality declined from 16.3% to 6.3%.
The findings, published in Diabetes and Metabolism Journal, showed that combining the caFFR coronary imaging system with SGLT2 inhibitor therapy significantly reduces the risks of major adverse cardiovascular events, heart failure, and death in patients with T2DM and coronary artery disease. This dual-pronged strategy pairs precise functional assessment of coronary blood flow with glucose-lowering therapy, offering an effective treatment approach for exceptionally high-risk patients.
The study highlights the complementary roles of precision interventional imaging and pharmacological therapy in improving outcomes for diabetic patients with coronary artery disease. By integrating caFFR-guided vascular reconstruction with SGLT2 inhibitor therapy, clinicians can better tailor treatment to individual patients, providing both anatomical and metabolic protection for the heart.
“This study has important implications for clinical practice. It demonstrates that even when structural risks in the blood vessels may persist, SGLT2 inhibitors provide a vital safety net, reducing future cardiovascular risks. The findings reinforce HKUMed’s ongoing commitment to translating clinical innovation into better patient care, ” said Professor Yiu Kai-hang, Clinical Professor at HKUMed.
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