冠状动脉CT血管成像血流储备分数对冠状动脉临界病变的预后评估价值OA

Objective:To investigate the prognostic value of coronary CT angiography(CCTA)fractional flow reserve(FFR)to the prognosis of patients with coronary heart disease(CHD)who had moderate coronary artery stenosis.Methods:A total of 289 CHD patients were retrospectively included,all of them underwent CCTA examination and were diagnosed with moderate coronary artery stenosis.The original DICOM data from CCTA images were imported into the Maiying CT-FFR module for post-processing to obtain the CT-FFR values.Clinical baseline data and the mortality and major adverse cardiovascular events(MACE)from discharge until the follow-up period were recorded.Initially,the patients were divided into two groups,the group of CT-FFR>0.8(112 cases)and the group of CT-FFR≤0.8(177 cases).Additionally,the patients were divided into two groups according to occurrence of MACE,the MACE group(60 cases)and the non-MACE group(229 cases).The clinical baseline data between groups were compared,and Cox regression analysis was employed to identify the independent risk factors for MACE.A risk prediction model was established,and the ROC curve was applied to evaluate the predictive ability of the model.Results:The incidence rate of MACE in the group of CT-FFR≤0.8 during the follow-up period was significantly higher than that in the group of CT-FFR>0.8(P<0.05).The history of diabetes,the incidence of multi-vessel disease and the proportion of patients with CT-FFR≤0.8 in the MACE group were significantly greater than those in the non-MACE group(all P<0.05).Multivariate Cox regression analysis indicated that CT-FFR≤0.8,the history of diabetes and multi-vessel disease were the independent risk factors for MACE,and were used to construct the Cox predictive model.The time-dependent ROC curve showed that the overall AUC of the predictive model was relatively high,with the model's sensitivity approaching 1.000 at the 8th and 16th months,while the specificities were relatively low at different time points.Conclusions:History of diabetes,multi-vessel disease,and CT-FFR≤0.8 are identified as independent risk factors for MACE in CHD patients with moderate coronary artery stenosis,which can assist in identifying patients at higher risk for MACE.The combined prediction model incorporating these three factors demonstrates good prognostic value for CHD patients with moderate coronary artery stenosis,enhancing MACE prediction capabilities,facilitating accurate stratification of CHD patients,and ultimately reducing myocardial risks and improving patient outcomes.