Prediction value of pericoronary fat attenuation index for coronary in-stent restenosis.
Eur Radiol
; 34(8): 4950-4959, 2024 Aug.
Article
em En
| MEDLINE
| ID: mdl-38224375
ABSTRACT
OBJECTIVES:
As a novel imaging marker, pericoronary fat attenuation index (FAI) reflects the local coronary inflammation which is one of the major mechanisms for in-stent restenosis (ISR). We aimed to validate the ability of pericoronary FAI to predict ISR in patients undergoing percutaneous coronary intervention (PCI). MATERIALS ANDMETHODS:
Patients who underwent coronary CT angiography (CCTA) before PCI within 1 week between January 2017 and December 2019 at our hospital and had follow-up invasive coronary angiography (ICA) or CCTA were enrolled. Pericoronary FAI was measured at the site where stents would be placed. ISR was defined as ≥ 50% diameter stenosis at follow-up ICA or CCTA in the in-stent area. Multivariable analysis using mixed effects logistic regression models was performed to test the association between pericoronary FAI and ISR at lesion level.RESULTS:
A total of 126 patients with 180 target lesions were included in the study. During 22.5 months of mean interval time from index PCI to follow-up ICA or CCTA, ISR occurred in 40 (22.2%, 40/180) stents. Pericoronary FAI was associated with a higher risk of ISR (adjusted OR = 1.12, p = 0.028). The optimum cutoff was - 69.6 HU. Integrating the dichotomous pericoronary FAI into current state of the art prediction model for ISR improved the prediction ability of the model significantly (â³area under the curve = + 0.064; p = 0.001).CONCLUSION:
Pericoronary FAI around lesions with subsequent stent placement is independently associated with ISR and could improve the ability of current prediction model for ISR. CLINICAL RELEVANCE STATEMENT Pericoronary fat attenuation index can be used to identify the lesions with high risk for in-stent restenosis. These lesions may benefit from extra anti-inflammation treatment to avoid in-stent restenosis. KEY POINTS ⢠Pericoronary fat attenuation index reflects the local coronary inflammation. ⢠Pericoronary fat attenuation index around lesions with subsequent stents placement can predict in-stent restenosis. ⢠Pericoronary fat attenuation index can be used as a marker for future in-stent restenosis.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Stents
/
Valor Preditivo dos Testes
/
Angiografia Coronária
/
Reestenose Coronária
/
Intervenção Coronária Percutânea
/
Angiografia por Tomografia Computadorizada
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Eur Radiol
/
Eur. radiol
/
European radiology
Assunto da revista:
RADIOLOGIA
Ano de publicação:
2024
Tipo de documento:
Article