冠状动脉周围脂肪衰减指数、Lp-PLA2与冠状动脉斑块特征及不良心血管事件的关联性分析OA

Objective To investigate the associations of the perivascular fat attenuation index(FAI)measured by coronary computed tomography angiography(CCTA)and plasma lipoprotein-associated phospholipase A2(Lp-PLA2)levels with coronary plaque characteristics and major adverse cardiovascular events(MACE),and to provide ima-ging and biological evidence for the early identification of high-risk coronary plaques and prediction of adverse cardiovas-cular events.Methods A total of 176 patients with coronary artery disease who were admitted to Yuebei People's Hospi-tal between January 2020 and September 2023 were retrospectively enrolled.According to the presence or absence of acute coronary syndrome(ACS),patients were divided into an ACS group(n=87)and a chronic coronary syndrome(CCS)group(n=89).General clinical characteristics,FAI,plasma Lp-PLA2 levels,coronary plaque parameters,and the in-cidence of MACE were compared between the two groups.Pearson correlation analysis was performed to evaluate the asso-ciations of FAI and Lp-PLA2 with coronary plaque parameters.Receiver operating characteristic(ROC)curve analysis was performed to assess the predictive value of FAI and Lp-PLA2 for MACE.Results Compared with the CCS group,the ACS group had significantly higher FAI and Lp-PLA2 levels(t=6.769 and 13.720,respectively;P＜0.05).The ACS group also had greater plaque length,plaque volume,and noncalcified plaque volume,as well as a higher incidence of MACE(t=11.500,16.930,76.450,and 13.111,respectively;P＜0.05),whereas the minimum lumen area was significantly smaller(t=18.740,P＜0.05).Compared with patients in the low-FAI group,those in the high-FAI group had greater plaque length,plaque volume,and noncalcified plaque volume,a higher incidence of MACE(t/x2 val-ues=13.360,14.950,6.772,and 4.148,respectively;P＜0.05),and a smaller minimum lumen area(t=4.339,P＜0.05).Similarly,compared with the low-Lp-PLA2 group,the high-Lp-PLA2 group showed greater plaque length,plaque volume,and noncalcified plaque volume,a higher incidence of MACE(t/x2 values=9.417,17.930,27.110,and 6.408,respectively;P＜0.05),and a smaller minimum lumen area(t=3.649,P＜0.05).Both FAI and Lp-PLA2 levels were positively correlated with plaque length,plaque volume,and noncalcified plaque volume,but nega-tively correlated with the minimum lumen area(all P＜0.05).The area under the ROC curve(AUC)for FAI in predic-ting MACE was 0.842,compared with 0.767 for Lp-PLA2 and 0.863 for their combination.The AUC of the combined assessment was significantly higher than that of either FAI or Lp-PLA2 alone(P＜0.05).Conclusion Both CCTA-derived FAI and plasma Lp-PLA2 levels were significantly elevated in patients with ACS.Higher FAI and Lp-PLA2 levels were associated with greater plaque burden,particularly longer plaques,greater plaque volume,and increased non-calcified plaque volume,as well as a higher risk of MACE.The combined assessment of FAI and Lp-PLA2 may provide complementary imaging and biological information for the identification of high-risk coronary plaque and prediction of ad-verse cardiovascular events.