冠状动脉CT血管成像FAI指数在冠状动脉粥样硬化患者预后评估中的应用价值

Value of pericoronary FAI on coronary computed tomography angiography in evaluating the prognosis of patients with coronary atherosclerosis

目的:探讨冠状动脉CT血管成像(Coronary computed tomography angiography,CCTA)冠状动脉周围脂肪衰减(Fat attenuation index,FAI)指数在冠状动脉粥样硬化患者预后评估的价值。方法:选取2020年1月~2022年1月我院收治的85例冠状动脉粥样硬化患者作为研究对象。均进行CCTA检查,测量斑块定量参数及测量冠周FAI指数。根据患者1 y内是否发生不良心血管事件分为预后不良组(n=20)和预后良好组(n=65)。比较两组斑块定量参数、FAI指数,并分析斑块定量参数与FAI指数的相关性,采用受试者工作特征(Receiver operating characteristic,ROC)曲线分析斑块定量参数与FAI指数预测冠状动脉粥样硬化患者预后的价值。结果:预后不良组斑块定量参数均高于预后良好组(P<0.05);预后不良组FAI指数高于预后良好组(P<0.05);总斑块负荷、非钙化斑块负荷、钙化斑块负荷、血管狭窄率、重建指数与FAI指数呈正相关(r=0.382、0.451、0.439、0.425、0.396,P均<0.05);斑块定量参数预测冠状动脉粥样硬化患者预后曲线下面积(Area under curve,AUC)为0.781,FAI指数预测冠状动脉粥样硬化患者预后AUC为0.733,两者预测冠状动脉粥样硬化患者预后均有一定的价值,但斑块定量参数与FAI指数联合预测冠状动脉粥样硬化患者预后AUC为0.839,高于单一预测价值。结论:基于CCTA定量斑块特征参数、冠周FAI指数与冠状动脉粥样硬化患者预后密切相关,两者联合用于评估心血管事件风险具有一定的参考价值。

Objective:To discuss the value of pericoronary fat attenuation index(FAI)on coronary computed tomography angiography(CCTA)in evaluating the prognosis of patients with coronary atherosclerosis.Methods:Eighty-five patients with coronary atherosclerosis in our hospital from January 2020 to January 2022 were enrolled.All patients underwent CCTA examinations.The quantitative measurements of coronary plaque and pericoronary FAI were performed.Patients were divided into good prognosis group(n=65)and poor prognosis group(n=20)according to major adverse cardiovascular events within one year.The quantitative parameters of atherosclerotic plaque and FAI were compared between two groups,and the correlation among the above indexes was explored,then receiver operating characteristic(ROC)curve was plotted to analyze the value of quantitative parameters of atherosclerotic plaque and FAI in predicting the prognosis of patients with coronary atherosclerosis.Results:The quantitative parameters of atherosclerotic plaque were remarkably better in poor prognosis group than in good prognosis group(P<0.05).FAI of poor prognosis group was higher than that of good prognosis group(P<0.05).The total plaque burden,calcified plaque burden,non-calcified plaque burden,vascular stenosis rate,and remodeling index were positively correlated with FAI(r=0.382,0.451,0.439,0.425,0.396,all P<0.05).The area under the curve(AUC)for predicting the prognosis of patients with coronary atherosclerosis was 0.781 under the curve of the quantitative parameters of plaques,and was 0.733 under the curve of FAI,indicating their value in prognosis prediction,while the largest ACU of 0.839 was obtained by the combined detection of quantitative parameters of atherosclerotic plaque and FAI,which was significantly larger than that of the separate detection.Conclusion:CCTA-based plaque quantitative parameters and FAI are closely correlated with prognosis of patients with coronary atherosclerosis,and the combined detection the above parameters is of certain value in evaluating the major adverse cardiovascular events in patients.