The predictive value of lesion-specific pericoronary fat attenuation index for major adverse cardiovascular events in patients with type 2 diabetes
Authors' conclusion
The elevated lesion-specific pericoronary FAI emerged as an independent prognostic factor for MACE in patients with T2DM, inclusive of those with moderate to severe coronary artery calcification. Incorporating lesion-specific pericoronary FAI with the CACS provided incremental predictive power for MACE in patients with T2DM.
Study context
- Population
- Patients with T2DM who underwent coronary CT angiography (coronary computed tomography angiography (CCTA)), December 2011 to October 2021, followed >3 years
- Participants
- 304 patients
- Exposure
- Lesion-specific pericoronary fat attenuation index (FAI) >−83.5 Hounsfield Units (HU) vs lower
- Major adverse cardiovascular events (MACE)n = 76
- Outcome
- MACE: cardiac death, acute coronary syndrome (unstable angina, MI), late coronary revascularization, HF hospitalisation
- Follow-up
- 3 years
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
MACE
−84.87
± 11.36 · HU
No MACE
−88.65
± 11.89 · HU
P = 0.016
- Lesion-specific pericoronary FAI higher than −83.5 HU independently associated with MACE (multivariate Cox): HR
- 2.400 (95% CI 1.399-4.120, p = 0.001)
- Coronary artery calcium score (CACS) ≥ 100 independently associated with MACE (multivariate Cox): HR
- 4.071 (95% CI 2.157-7.683, p < 0.001)
- Kaplan-Meier: higher lesion-specific pericoronary FAI more likely to develop MACE
- P = 0.0023
Observational data: associations, not effects.
Further findings
High-risk plaques by lesion-specific pericoronary FAI
- Lesions with higher lesion-specific pericoronary FAI had a greater proportion of high-risk plaques
- P = 0.015
MACE in subgroup with moderate to severe coronary calcification
- Lesion-specific pericoronary FAI higher than −83.5 HU independently correlated with MACE: HR
- 2.017 (95% CI 1.143-3.559, p = 0.015)
Combined CACS ≥ 100 and lesion-specific pericoronary FAI >−83.5 HU · 3 years
- Combination significantly enhanced predictive value for MACE
Original publication
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