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Published:
Oct 6, 2024DOI:
10.4314/ahs.v24i3.49Keywords:
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Main Article Content
Added prognostic value of fat attenuation index and CT-derived fractional flow reserve over plaque burden in suspected CAD patients without standard modifiable risk factors
Abstract
Background: In this study, we aimed to investigate the added prognostic value of fat attenuation index (FAI) and CT-derived
fractional flow (CT-FFR) over plaque burden in suspected coronary artery disease (CAD) patients without standard modifiable
risk factors (SMuRFs).
Methodology: A total of 260 consecutive suspected CAD subjects without SMuRFs who underwent first coronary computed tomography angiography (CCTA) were retrospectively collected. We calculated FAI, CT-FFR, and segment involvement score (SIS) from CCTA images. Cox regression models were used to assess the incremental prognostic value of FAI and CT-FFR.
Results: During a median follow-up of 25.00 months, major adverse cardiovascular events (MACE) were observed in 40 (15.4%) patients. FAI ≥ −70.1, CT-FFR ≤ 0.80, and SIS ≥ 4.5 were associated with the increased rate of MACE (P < 0.0001). FAI did not provide incremental prognostic value over SIS (P = 0.169). Likewise, CT-FFR did not enhance risk prediction (P = 0.159). Combining FAI and CT-FFR added incremental prediction value and improved risk discrimination (P = 0.032; Absolute integrate discrimination improvement (IDI) = 0.070, P < 0.001).
Conclusion: In suspected CAD patients without SMuRFs, neither FAI nor CT-FFR independently added incremental prognostic value over plaque burden. Combining FAI and CT-FFR had added prognostic value and improved cardiovascular risk stratification.
Keywords: Coronary artery disease; CT-derived fractional flow reserve; fat attenuation index; plaque burden; standard cardiovascular
risk factor; prognosis.
