Prognostic efficacy of pericoronary fat attenuation index and fibrous plaque index in patients with acute coronary syndrome
10.16016/j.2097-0927.202506062
- VernacularTitle:冠状动脉周围脂肪衰减指数与纤维斑块指数预测急性冠状动脉综合征患者预后的效能研究
- Author:
Cong HUANG
1
;
Feng WEN
;
Xinglan WANG
;
Chen LIU
;
Hongqin LIANG
;
Xi YANG
;
Chengwei MOU
;
Jian WANG
Author Information
1. 陆军军医大学第一附属医院放射科
- Keywords:
pericoronary adipose tissue;
pericoronary fat attenuation index;
fibrous plaque index;
acute coronary syndrome;
major adverse cardiovascular events
- From:
Journal of Army Medical University
2025;47(17):2106-2114
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the predictive value of fat attenuation index(FAI)and fibrous plaque index(FPI)for the prognosis of patients with acute coronary syndrome(ACS).Methods A retrospective cohort study was conducted on 334 ACS patients undergoing percutaneous coronary intervention(PCI)in the First Affiliated Hospital of Army Military Medical University and Yongchuan Hospital of Chongqing Medical University from March 2021 to July 2023.All patients received coronary computed tomography angiography(CCTA)to measure FAI and FPI.According to the occurrence of major adverse cardiovascular events(MACE)with 1 year of follow-up,they were divided into MACE group(n=108)and non-MACE group(n=226).The baseline data,CCTA data and results of laboratory tests were collected and compared between the 2 groups.Multivariate logistic regression analysis was used to analyze the relationship of FAI and FPI with the prognosis of ACS patients,and ROC curve was drawn to evaluate its predictive efficiency.Results Among the 334 ACS patients,108(32.34%)experienced MACE.When compared with the non-MACE group,the MACE group exhibited significantly larger proportions of diabetes(72.22%vs 31.86%)and left main coronary artery disease(18.52%vs 7.08%),but lower success rate of operation(79.63%vs 93.81%,P<0.05).Radiologic results showed that the proportion of severe stenosis(20.37%vs 10.62%),FAI(-80.12±6.41 HU vs-72.34±7.09 HU)and FPI(0.58±0.41 vs 0.26±0.12)were obviously increased in the MACE group than the non-MACE group(P<0.05).Laboratory tests indicated that there were statistical differences between the 2 groups in high-density lipoprotein-cholesterol(HDL-C,1.20±0.15 vs 1.09±0.16 mmol/L),miR-126(0.91±0.12 vs 0.96±0.15)and SST2(38.45±5.67 vs 34.30±4.89 ng/mL,P<0.05).Multivariate Logistic regression analysis revealed that FAI(OR=1.200,95%CI:1.136~1.268),FPI(OR=63.157,95%CI:14.126~282.374),moderate stenosis(OR=1.332,95%CI:1.024~1.859),severe stenosis(OR=1.480,95%CI:1.074~2.039),miR-126(OR=0.007,95%CI:0.001~0.077),and sST2(OR=1.192,95%CI:1.113~1.277)were independent predictors of MACE(P<0.05).ROC curve analysis displayed that stenosis degree(AUC=0.622,95%CI:0.561~0.683,P=0.001),FAI(AUC=0.790,95%CI:0.741~0.839,P=0.001)and FPI(AUC=0.700,95%CI:0.638~0.761,P=0.001),miR-126(AUC=0.646,95%CI:0.584~0.707,P=0.001),sST2(AUC=0.700,95%CI:0.638~0.761,P=0.001)had certain predictive values for ACS prognosis.Conclusion Coronary FAI and FPI can be used as independent prognostic indicators of ACS patients,and their numerical changes are closely related to plaque stability and inflammatory state.