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Kaplan-Meier analysis showed significantly reduced event-free and overall survival in MFR groups 2 and 3 compared to MFR group 1 (log-rank p = 0.015 and p = 0.013). In a multivariable Cox regression analysis, decreased regional MFR was an independent predictor for MACE (adjusted HR 3.44, 95% CI 1.17-10.11, p = 0.024) and all-cause death (adjusted HR 4.72, 95% CI 1.07-20.7, p = 0.04). A decreased regional MFR as assessed by 13N-ammonia PET-MPI confers prognostic value by identifying patients at increased risk for future adverse cardiac o