Explore the Influencing Factors and Predictive Value of Myocardial Injury after Percutaneous Coronary Intervention Based on Quantitative Analysis of Coronary Plaque
Objective:To investigate the influencing factors and predictive value of perioperative myocardial injury(PMI)after percutaneous coronary intervention(PCI)based on quantitative analysis of coronary plaque.Methods:A retrospective analysis of 251 pa-tients who were hospitalized in our hospital from August 2020 to December 2022 and underwent elective PCI surgery was performed.According to the presence or absence of elevated serum biomarkers after PCI,they were divided into PMI positive group(n=106)and PMI negative group(n=145).All patients underwent coronary CT angiography(CCTA)1 week before PCI,and the level of high-sensi-tivity cardiac troponin T(hs-cTnT)was measured before and 24 hours after PCI.Semi-automatic plaque analysis software was used to la-bel and analyze plaque characteristics,mainly to measure the degree of coronary anatomical stenosis and to quantitatively analyze plaque composition and morphological characteristics.The clinical data and plaque quantitative indexes of the two groups were compared by one-way analysis of variance.The risk factors of PMI after PCI were determined by multivariate Logistic regression analysis.Receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of quantitative indexes of coronary plaque for PMI after PCI.Results:One-way analysis of variance showed that the maximum area stenosis rate,total plaque volume,plaque load,lipid plaque vol-ume,lipid plaque proportion and fibrous plaque volume were related to the occurrence of PMI after PCI(P＜0.05),while the Plaque length,the narrowest area of lumen,the proportion of fibrous plaque,the calcified plaque volume,the proportion of calcified plaque,Spotted calcification,ring sign of napkin,reconstruction index and eccentricity index were not related to the occurrence of PMI after PCI(P＞0.05).Multivariate Logistic regression analysis showed that the maximum area stenosis rate and the proportion of lipid plaques were risk factors for PMI after PCI(P＜0.05).ROC results showed that the diagnostic value of the combined application of the maximum area stenosis rate and the proportion of lipid plaques was higher than that of the two alone.Conclusion:Quantitative analysis of coronary plaque has a certain clinical diagnostic value for the occurrence of PMI in PCI patients,among which the maximum area stenosis rate and the proportion of lipid plaque have higher diagnostic accuracy for PMI.
Coronary artery plaquePCIMyocardial injuryInfluencing factorsPredictive value
NETL
NSTL
万方数据
