血管斑块特征及脂肪衰减指数对冠心病心肌缺血的预测价值OA

Objective:To explore the predictive value of plaque characteristics and pericoronal fat attenuation index(FAI)in the diagnosis of myocardial ischemia in coronary heart disease.Methods:A retrospective analysis was performed on 265 patients with coronary heart disease(398 coronary arteries).And the plaque characteristics,the proximal FAI of the three main coronary arteries and CT fractional flow reserve(CT-FFR)were measured.The patients were divided into the myocardial ischemia group(91 cases,CT-FFR≤0.8)and non-myocardial ischemia group(174 cases,CT-FFR>0.8)according to CT-FFR values.Logistic regression analysis was used to evaluate the independent predictors of myocardial ischemia in coronary heart disease.The ROC curves were plotted to analyze the performance of the independent predictors on myocardial ischemia in coronary heart disease.Results:There was a statistically significant difference in the proportion of diabetes between the two groups(P<0.05).The myocardial ischemia group showed a longer lesion,more severe degree of coronary artery stenosis,more obvious degree of the positive remodeling,larger volume of plaque and calcification,a larger FAI,and a larger proportion of low-density plaques compared to the non-myocardial ischemia group(all P<0.05).Univariate and multivariate logistic regression analysis revealed that diabetes,degree of coronary artery stenosis and FAI were the independent predictors of myocardial ischemia in coronary heart disease(all P<0.05).ROC curve analysis showed that the AUC values for diagnosing myocardial ischemia in coronary heart disease by diabetes,degree of coronary artery stenosis and FAI were 0.564,0.812 and 0.708,respectively,and the AUC for the combined diagnosis was 0.850.Conclusion:Diabetes mellitus,stenosis degree and FAI have good predictive value in the diagnosis of myocardial ischemia in coronary heart disease.