The role of pericoronary fat thickness in prediction of long-term outcomes after percutaneous coronary intervention for chronic total occlusions

Introduction: Pericoronary fat thickness (PFT) is a well-established marker crucial for evaluating the extent and severity of coronary artery disease (CAD).While its role in CAD is widely acknowledged, a considerable gap exists in understanding the prognostic implications of PFT after percutaneous coronary intervention (PCI), specifically for coronary chronic total occlusions (CTO).Aim: This study investigated the relationship between PFT and prognostic outcomes in patients undergoing PCI for CTO.Material and methods: A retrospective study analyzed data from 415 patients who had undergone coronary computed tomography angiography (CCTA) and coronary angiography (CAG).PFT measurements were taken, and patients were categorized into normal, PCI (non-CTO), and CTO-PCI groups.Prognostic implications within the CTO-PCI group were evaluated based on survival status.Results: PFT measurements varied significantly among groups.The CTO-PCI group had a 13.9% mortality rate over a median follow-up of 16.6 10.3 months.Higher average PFT values were found in the non-survival group (p = 0.013).ROC curve analysis identified an average PFT cut-off value of 13.6 mm (AUC = 0.682, p = 0.011).Cox regression analysis linked mortality with LVEF (HR = 0.938, p = 0.001), albumin (HR = 0.189, p = 0.006), and average PFT (HR = 1.252, p = 0.040).Elevated average PFT was associated with higher mortality (p = 0.001).Conclusions: PFT is a significant inflammatory marker and a promising prognostic indicator following PCI for CTO.Integrating PFT into risk prediction models may enhance prognostic accuracy and aid in timely clinical interventions.