Synergistic prognostic value of coronary distensibility index and fractional flow reserve based cCTA for major adverse cardiac events in patients with Coronary artery disease
Abstract Background Coronary distensibility index (CDI), as an early predictor of cardiovascular diseases, has the potential to complement coronary computed tomography angiography (cCTA)-derived fractional flow reserve (CT-FFR) for predicting major adverse cardiac events (MACEs). Thus, the prognosti...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-022-02655-0 |
| _version_ | 1818203823871623168 |
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| author | Xiao-long Zhu Zhi-ying Pang Wei Jiang Ting-yu Dong |
| author_facet | Xiao-long Zhu Zhi-ying Pang Wei Jiang Ting-yu Dong |
| author_sort | Xiao-long Zhu |
| collection | DOAJ |
| description | Abstract Background Coronary distensibility index (CDI), as an early predictor of cardiovascular diseases, has the potential to complement coronary computed tomography angiography (cCTA)-derived fractional flow reserve (CT-FFR) for predicting major adverse cardiac events (MACEs). Thus, the prognostic value of CT-FFR combined with CDI for MACEs is worth exploring. Methods Patients with a moderate or severe single left anterior descending coronary artery stenosis were included and underwent FFR and CDI analysis based on cCTA, followed up at least 1 year, and recorded MACEs. Multivariate logistic regression analysis was performed to determine independent predictors of MACEs. The area under of receiver operating characteristic (ROC) curve was used to evaluated evaluate the diagnostic performance of CT-FFR, CDI, and a combination of the two. Results All the vessel-specific data were from LAD. 150 patients were analysed. 55 (37%) patients experienced MACEs during follow-up. Patients with CT-FFR ≤ 0.8 had higher percentage of MACEs compared with CT-FFR > 0.8 (56.3% vs.7.3%, p < 0.05). Patients’ CDI was significantly decreased in MACEs group compared with non-MACEs group (p < 0.05). Multivariate analysis revealed that diabetes (p = 0.025), triglyceride (p = 0.015), CT-FFR ≤ 0.80 (p = 0.038), and CDI (p < 0.001) are independent predictors of MACEs. According to ROC curve analysis, CT-FFR combined CDI showed incremental diagnostic performance over CT-FFR alone for prediction of MACEs (AUC = 0.831 vs. 0.656, p = 0.0002). Conclusion Our study provides initial evidence that combining CDI with CT-FFR shows incremental discriminatory power for MACEs over CT-FFR alone, independent of clinical risk factors. Diabetes and triglyceride are also associated with MACEs. |
| first_indexed | 2024-12-12T03:31:28Z |
| format | Article |
| id | doaj.art-8d3af4ad450746209d36ccfbccbff6cb |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-12T03:31:28Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-8d3af4ad450746209d36ccfbccbff6cb2022-12-22T00:39:55ZengBMCBMC Cardiovascular Disorders1471-22612022-05-012211910.1186/s12872-022-02655-0Synergistic prognostic value of coronary distensibility index and fractional flow reserve based cCTA for major adverse cardiac events in patients with Coronary artery diseaseXiao-long Zhu0Zhi-ying Pang1Wei Jiang2Ting-yu Dong3Department of Medical Imaging, The First Affiliated Hospital of Hebei North UniversityGraduate School of Hebei North UniversityThe Medical Engineering Office, The First Affiliated Hospital of Hebei North UniversityGraduate School of Hebei North UniversityAbstract Background Coronary distensibility index (CDI), as an early predictor of cardiovascular diseases, has the potential to complement coronary computed tomography angiography (cCTA)-derived fractional flow reserve (CT-FFR) for predicting major adverse cardiac events (MACEs). Thus, the prognostic value of CT-FFR combined with CDI for MACEs is worth exploring. Methods Patients with a moderate or severe single left anterior descending coronary artery stenosis were included and underwent FFR and CDI analysis based on cCTA, followed up at least 1 year, and recorded MACEs. Multivariate logistic regression analysis was performed to determine independent predictors of MACEs. The area under of receiver operating characteristic (ROC) curve was used to evaluated evaluate the diagnostic performance of CT-FFR, CDI, and a combination of the two. Results All the vessel-specific data were from LAD. 150 patients were analysed. 55 (37%) patients experienced MACEs during follow-up. Patients with CT-FFR ≤ 0.8 had higher percentage of MACEs compared with CT-FFR > 0.8 (56.3% vs.7.3%, p < 0.05). Patients’ CDI was significantly decreased in MACEs group compared with non-MACEs group (p < 0.05). Multivariate analysis revealed that diabetes (p = 0.025), triglyceride (p = 0.015), CT-FFR ≤ 0.80 (p = 0.038), and CDI (p < 0.001) are independent predictors of MACEs. According to ROC curve analysis, CT-FFR combined CDI showed incremental diagnostic performance over CT-FFR alone for prediction of MACEs (AUC = 0.831 vs. 0.656, p = 0.0002). Conclusion Our study provides initial evidence that combining CDI with CT-FFR shows incremental discriminatory power for MACEs over CT-FFR alone, independent of clinical risk factors. Diabetes and triglyceride are also associated with MACEs.https://doi.org/10.1186/s12872-022-02655-0Coronary artery disease (CAD)Coronary distensibility index (CDI)Fractional flow reserve (FFR)Coronary computed tomographic angiography (cCTA)Major adverse cardiac events (MACEs) |
| spellingShingle | Xiao-long Zhu Zhi-ying Pang Wei Jiang Ting-yu Dong Synergistic prognostic value of coronary distensibility index and fractional flow reserve based cCTA for major adverse cardiac events in patients with Coronary artery disease BMC Cardiovascular Disorders Coronary artery disease (CAD) Coronary distensibility index (CDI) Fractional flow reserve (FFR) Coronary computed tomographic angiography (cCTA) Major adverse cardiac events (MACEs) |
| title | Synergistic prognostic value of coronary distensibility index and fractional flow reserve based cCTA for major adverse cardiac events in patients with Coronary artery disease |
| title_full | Synergistic prognostic value of coronary distensibility index and fractional flow reserve based cCTA for major adverse cardiac events in patients with Coronary artery disease |
| title_fullStr | Synergistic prognostic value of coronary distensibility index and fractional flow reserve based cCTA for major adverse cardiac events in patients with Coronary artery disease |
| title_full_unstemmed | Synergistic prognostic value of coronary distensibility index and fractional flow reserve based cCTA for major adverse cardiac events in patients with Coronary artery disease |
| title_short | Synergistic prognostic value of coronary distensibility index and fractional flow reserve based cCTA for major adverse cardiac events in patients with Coronary artery disease |
| title_sort | synergistic prognostic value of coronary distensibility index and fractional flow reserve based ccta for major adverse cardiac events in patients with coronary artery disease |
| topic | Coronary artery disease (CAD) Coronary distensibility index (CDI) Fractional flow reserve (FFR) Coronary computed tomographic angiography (cCTA) Major adverse cardiac events (MACEs) |
| url | https://doi.org/10.1186/s12872-022-02655-0 |
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