Study on the Predictive Value of Quantitative Parameters of Coronary CTA for Major Adverse Cardiac Events in Patients with Coronary Heart Disease
Objective To explore the application value of quantitative parameters of coronary computed tomography angiography(CTA)in predicting major adverse cardiac events(MACE)in patients with coronary heart disease(CHD).Methods A retrospective analysis was conducted on the clinical data of 388 CHD patients treated at the People's Hospital of Kaizhou District,Chongqing from January 2021 to July 2022.Patients who developed MACE within 1 year of follow-up were included in the adverse group(70 cases),while patients who did not develop MACE were included in the non adverse group(318 cases).Coronary CTA examination was conducted in both groups,and the clinical data and quantitative parameters of coronary CTA were compared.The risk factors of MACE in patients with CHD were analyzed by multivariate Logistic regression analysis.The predictive value of CTA quantitative parameters for MACE in patients with CHD was analyzed using the receiver operating characteristic(ROC)curve.Results The proportion of patients with diabetes history,drinking history and family history of CHD in the adverse group were 61.43％,24.29％and 21.43％respectively,higher than 35.85％,12.89％and 9.75％in the non adverse group;Compared to the non adverse group,the adverse group had higher non calcified plaque volume,remodeling index,total plaque volume,total plaque load,and smaller minimum lumen area;The minimum density value of patches was lower(P＜0.05).Multivariate Logistic regression analysis showed that the independent risk factors of MACE in CHD patients included history of diabetes,high total plaque load,high remodeling index,and low minimum plaque density(OR=2.479,2.838,2.662,2.776,P＜0.05).The total plaque load,remodeling index,minimum plaque density value,and the area under the curve(AUC)predicted by combined examination for MACE in patients with CHD were 0.700,0.768,0.747,and 0.940,respectively,with sensitivity of 64.29％,68.57％,67.14％,and 85.71％,and specificity of 70.13％,71.70％,70.44％,and 92.45％,respectively.Among them,the AUC,sensitivity,and specificity of combined examination were the highest(P＜0.05).Conclusion The history of diabetes,high total plaque load,high remodeling index,and low minimum plaque density were independent risk factors for MACE in patients with CHD.The total plaque load,remodeling index,and minimum plaque density had high application value in predicting MACE,and the joint detection had the highest predictive value.
Coronary Heart DiseaseMajor Adverse Cardiac EventsRisk FactorsPredictive Value
万方数据
维普
