Risk stratification assessment of patients with acute coronary syndrome and stable coronary artery disease based on coronary perivascular fat attenuation index
10.3969/j.issn.1672-8467.2025.06.007
- VernacularTitle:基于冠周脂肪衰减指数对急性冠脉综合征和稳定型冠心病患者的风险分层评估
- Author:
Hong-yan LIN
1
;
Wei HE
;
Yi-ge LU
;
Yao-yi ZHANG
;
Wen-feng YAO
;
Shan YANG
;
Meng-su ZENG
;
Wei-feng GUO
Author Information
1. 复旦大学上海医学院,上海 200032;复旦大学附属中山医院放射科 上海 200032
- Publication Type:Journal Article
- Keywords:
coronary computed tomography angiography(CCTA);
coronary artery disease(CAD);
fat attenuation index(FAI);
fractional flow reserve(FFR);
plaque
- From:
Fudan University Journal of Medical Sciences
2025;52(6):829-836,867
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the differences in coronary-based and lesion-based fat attenuation index(FAI)in patients with coronary artery disease(CAD)across different risk stratifications,and to compare the diagnostic efficiency of coronary-based and lesion-based FAI in stable CAD patients with myocardial ischemia.Methods The patients with CAD,who underwent preoperative coronary CT angiography(CCTA)and invasive coronary angiography(ICA)with coronary fractional flow reserve(FFR)measurement between Apr 2019 and Oct 2022 in Zhongshan Hospital,Fudan University,were retrospectively collected.There were 57 cases of acute coronary syndrome(ACS)patients and 206 cases of stable CAD patients included following inclusion criteria.The coronary-based and lesion-based FAI were measured,and the differences in these indices were recorded and analyzed among ACS patients,ischemic and non-ischemic groups of stable CAD patients(FFR=0.8 as the threshold).ROC curves were utilized to assess the diagnostic efficiency of coronary-based and lesion-based FAI for myocardial ischemia in stable CAD patients.Results The coronary-based FAI and lesion-based FAI in ACS patients were significantly higher than those in stable CAD patients[coronary-based FAI:(-72.40±6.83)HU vs.(-76.82±9.01)HU,P<0.001;lesion-based FAI:(-65.65±4.79)HU vs.(-77.48±8.64)HU,P<0.001].Among stable CAD patients,the lesion-based FAI in the ischemic group was significantly higher than that in the non-ischemic group[(-69.28±5.65)HU vs.(-80.10±7.75)HU,P<0.001].The diagnostic efficiency of lesion-based FAI for predicting myocardial ischemia in stable CAD patients was superior to coronary-based FAI(AUC:0.892 vs.0.525,Z=9.803,P<0.001).Conclusion Coronary-based and lesion-based FAI tended to be higher in ACS patients than in stable CAD patients,suggesting a potential for stratifying CAD patients with different risks.Lesion-based FAI showed some promise in evaluating myocardial ischemia among stable CAD patients.
