冠状动脉周围脂肪衰减指数联合斑块特征预测稳定型心绞痛进展风险
The value of pericoronary fat attenuation index combined with plaque characteristics for predicting the risk of progression in stable angina pectoris
祝婷婷 1管汉雄 1李茜 1李德福2
作者信息
- 1. 430030 湖北武汉,华中科技大学同济医学院附属同济医院放射科
- 2. 430030 湖北武汉,华中科技大学同济医学院附属同济医院放射科;518103 广东深圳,深圳市宝安区福永人民医院放射科
- 折叠
摘要
目的:探讨冠状动脉周围脂肪衰减指数(FAI)联合斑块特征在预测稳定型心绞痛发生重大不良心脏事件(MACE)风险中的应用价值.方法:回顾性分析2020年1月—2022年12月在本院首次确诊的274例稳定型心绞痛患者的冠状动脉CTA资料.分析冠状动脉三大主支(右冠状动脉、左前降支和左旋支)近段的管腔狭窄程度和斑块特征(包括每支血管斑块内的脂类、纤维脂类、纤维和钙化成分体积及占比)及其周围的FAI.根据随访期间是否发生MACE,将患者分为进展组和稳定组.采用受试者工作特征(ROC)曲线评估FAI联合斑块特征对稳定型心绞痛发生MACE的预测效能.结果:中位随访时间12(7,28)月后,274例中63例发生MACE.与稳定组相比,进展组的FAI值显著较高(P=0.001),重度狭窄(≥70％)占比较大(P<0.001),脂类成分体积明显较大(P<0.001).FAI联合斑块的脂类成分体积及管腔狭窄程度构建的联合模型,预测稳定型心绞痛发生MACE的效能明显优于仅采用斑块特征和狭窄程度的模型(AUC分别为0.713和0.644,P=0.006).结论:FAI联合斑块的脂类成分体积及管腔狭窄程度可以较准确地预测稳定型心绞痛患者发生MACE的风险,为临床识别高危稳定型心绞痛患者提供帮助.
Abstract
Objective:The purpose of this study was to investigate the application value of peri-coronary fat attenuation index (FAI)in predicting the risk of major adverse cardiac events (MACE)in stable angina pectoris.Methods:Coronary CTA data of 274 patients with stable angina pectoris diag-nosed for the first time between January 2020 and December 2022 in our hospital were retrospectively analyzed.Proximal peripheral FAI,degree of luminal stenosis,and plaque characteristics of the three main coronary arteries (right coronary artery,left anterior descending branch,and left circumflex branch)were analyzed.Plaque characteristics included the volume and percentage of lipid,fibrolipid,fi-brous and calcified components within the plaque of each vessel.Patients were categorized into pro-gression and stable groups based on whether MACE occurred during the follow-up period.The predic-tive efficacy of FAI combined with plaque characterization for the development of MACE in patients with stable angina was assessed using the receiver operating characteristic (ROC)curve.Results:After a median follow-up time of 12 (7,28)months,MACE occurred in 63 of 274 cases.Compared with the stable group,the progression group had a significantly higher FAI values (P=0.001),a greater pro-portion of severe stenosis (≥70％,P<0.001),and a significantly larger volume of lipid component (P<0.001).The area under the ROC curve (AUC)of FAI combined with the volume of lipid compo-nent of plaque and severe luminal stenosis to diagnose progression of MACE in patients with stable an-gina was significantly better than that predicted by the model using only plaque characteristics and the degree of stenosis (AUC:0.713 vs.0.644,P=0.006).Conclusion:FAI combined with the volume of the lipid component of the plaque and the degree of luminal stenosis can more accurately predict the risk of MACE in patients with stable angina pectoris,and may provide clinical assistance in identifying patients with high-risk stable angina pectoris.
关键词
心绞痛/动脉粥样硬化/体层摄影术,X线计算机/脂肪衰减指数Key words
Angina pectoris/Atherosclerosis/Tomography,X-ray computed/Fat attenuation index引用本文复制引用
基金项目
湖北省自然科学基金面上项目(2022CFB210)
出版年
2024
NETL
NSTL
万方数据