Long-term prognostic value of coronary CT angiography-derived fractional flow reserve in elderly patients with CHD
10.3969/j.issn.1009-0126.2023.12.006
- VernacularTitle:基于冠状动脉CT血流储备分数预测老年冠心病患者远期结局的研究
- Author:
Jingzhou JIANG
1
;
Xiang GUO
;
Rui ZUO
;
Qian CHEN
;
Hongyan QIAO
;
Bangjun GUO
;
Pengpeng XU
;
Tongyuan LIU
;
Longjiang ZHANG
Author Information
1. 221004 徐州医科大学医学影像学院
- Keywords:
coronary disease;
fractional flow reserve,myocardial;
computed tomography angiogra-phy;
forecasting;
risk factors;
major adverse cardiovascular events
- From:Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2023;25(12):1255-1259
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the long-term prognostic value of coronary CT angiography-derived fractional flow reserve(CT-FFR)in elderly patients with coronary heart disease(CHD).Methods A retrospective analysis was performed on 1133 patients with clinically suspected CHD from a prospective observational study based on coronary CTA and CT-FFR at the General Hos-pital of Eastern Theater from April 2018 to March 2019,and 330 elderly CHD patients were even-tually included.According to major adverse cardiovascular events(MACE)occurred or not,295 patients were assigned into non-MACE group and 35 patients into the MACE group.Based on cor-onary CTA data,plaque features were analyzed and CT-FFR values were measured in all lesioned vessels.The relationship of plaque features and CT-FFR with MACE was evaluated by using Cox proportional risk regression model,Kaplan-Meier survival curve,and ROC curve analyses.Results The patients with coronary stenosis(≥50％)or CT-FFR value ≤0.8 had a higher risk of MACE(P＜0.01).Univariate Cox analysis showed that coronary stenosis ≥50％and CT-FFR value 0.8 were risk factors of MACE(P＜0.01).After adjusting confounding factors,multivariate Cox analysis indicated that CT-FFR ≤0.8(HR=17.037,95％CI:5.060-57.358,P=0.000)was only independent predictor for MACE.The risk prediction model based on CT-FFR presented better performance than the model based on coronary CTA stenosis(C-index:0.820 vs 0.696,P=0.000).Conclusion CT-FFR≤0.8 is an important independent predictor for long-term MACE in elderly CHD patients.Clinical risk stratification based on CT-FFR may optimize prognostic man-agement strategies in these patients.
