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- Title
Prediction value of pericoronary fat attenuation index for coronary in-stent restenosis.
- Authors
Lu, Zhong-Fei; Yin, Wei-Hua; Schoepf, U. Joseph; Abrol, Sameer; Ma, Jing-Wen; Zhao, Li; Su, Xiao-Ming; An, Yun-Qiang; Xiao, Zhi-Cheng; Lu, Bin
- 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 and methods: 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 (△area 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.
- Subjects
EPICARDIAL adipose tissue; CORONARY restenosis; PERCUTANEOUS coronary intervention; CORONARY angiography; DRUG-eluting stents
- Publication
European Radiology, 2024, Vol 34, Issue 8, p4950
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-023-10527-0