Peri-coronary adipose tissue volume (PCATV) predicted MACCE better (AUC 0.89) than DL-FFRCT (AUC 0.76), and combined use improved prediction to AUC 0.91 in chronic coronary syndrome.
Do PCATV and DL-FFRCT predict major adverse cardiac and cerebrovascular events in patients with chronic coronary syndromes?
PCATV is a strong independent predictor of MACCE in patients with chronic coronary syndromes, and its predictive value is further enhanced when combined with DL-FFRCT.
Absolute Event Rate: 0% vs 0%
Abstract Background Coronary computed tomography angiography (CCTA) is a helpful tool in diagnosing coronary artery disease (CAD). Noninvasive imaging markers like peri-coronary adipose tissue volume (PCATV) and Computed Tomography Derived Fractional Flow Reserve (FFRCT) have attracted significant attention due to their prognostic potential. Purpose To investigate the prognostic value of deep-learning based FFRCT (DL-FFRCT) and PCATV alone and in combination for outcome of patients with chronic coronary syndromes (CCS). Methods A retrospective pooled analysis of data from 268 CCS patients who underwent CCTA between January 2015 and March 2021 was performed. PCATV and DL-FFRCT were calculated. The individual and combined predicting efficacy of PCATV and DL-FFRCT for outcome was assessed in these patients. The mean follow-up time was 32 months. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE) encompassed all-cause mortality, non-fatal myocardial infarction, stroke and cardiovascular hospitalization. Results Based on the optimal cut-off value of PCATV, patients (mean age, 64.41±11.81 years, 63.81% male) were categorized into low (7.03 cm³, n=195) and high (≥7.03 cm³, n=73) PCATV groups. The independent risk factors for high PCATV included age(OR:1.03; 95% CI:1.00,1.06; P=0.03), DL-FFRCT≤0.8 (OR:2.92; 95% CI;1.51,5.64; P=0.001), while the independent risk factors for low DL-FFRCT included PCATV≥7.03 cm³(OR:2.80; 95% CI:1.40,5.61; P=0.004) and total calcification score (TCS) (OR:1.002; 95% CI:1.001,1.002; P0.001),among others. PCATV was a superior predictor for MACCE as compared to DL-FFRCT (AUC: 0.89 vs. 0.76; P0.001). Combining PCATV with DL-FFRCT further increased the AUC to 0.91 (P0.001 vs. P0.001 vs. P0.001). Kaplan-Meier analysis further underscored the negative impacts of elevated PCATV and reduced DL-FFRCT on patient outcomes. Conclusions PCATV is a novel and superior outcome predictor compared to DL-FFRCT in CCS patients. This study highlights the importance of combined assessment of PCATV and DL-FFRCT for the risk stratification in CCS patients. Graphical Abstract
Wang et al. (Sat,) reported a other. Peri-coronary adipose tissue volume (PCATV) predicted MACCE better (AUC 0.89) than DL-FFRCT (AUC 0.76), and combined use improved prediction to AUC 0.91 in chronic coronary syndrome.