Celik Aziz Inan, Bezgin Tahir, Kodal Burcu, Oner Emre, Tanalp Ali Cevat, Cagdas Metin
Department of Cardiology, Gebze Fatih State Hospital, Kocaeli, Turkey.
Department of Emergency Medicine, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK.
Postepy Kardiol Interwencyjnej. 2024 Sep;20(3):285-293. doi: 10.5114/aic.2024.142232. Epub 2024 Aug 13.
Pericoronary fat thickness (PFT) is a well-established marker crucial for evaluating the extent and severity of coronary artery disease (CAD). While its role in CAD is widely acknowledged, a considerable gap exists in understanding the prognostic implications of PFT after percutaneous coronary intervention (PCI), specifically for coronary chronic total occlusions (CTO).
This study investigated the relationship between PFT and prognostic outcomes in patients undergoing PCI for CTO.
A retrospective study analyzed data from 415 patients who had undergone coronary computed tomography angiography (CCTA) and coronary angiography (CAG). PFT measurements were taken, and patients were categorized into normal, PCI (non-CTO), and CTO-PCI groups. Prognostic implications within the CTO-PCI group were evaluated based on survival status.
PFT measurements varied significantly among groups. The CTO-PCI group had a 13.9% mortality rate over a median follow-up of 16.6 ±10.3 months. Higher average PFT values were found in the non-survival group ( = 0.013). ROC curve analysis identified an average PFT cut-off value of 13.6 mm (AUC = 0.682, = 0.011). Cox regression analysis linked mortality with LVEF (HR = 0.938, = 0.001), albumin (HR = 0.189, = 0.006), and average PFT (HR = 1.252, = 0.040). Elevated average PFT was associated with higher mortality ( = 0.001).
PFT is a significant inflammatory marker and a promising prognostic indicator following PCI for CTO. Integrating PFT into risk prediction models may enhance prognostic accuracy and aid in timely clinical interventions.
冠状动脉周围脂肪厚度（PFT）是评估冠状动脉疾病（CAD）范围和严重程度的一个公认的重要指标。虽然其在CAD中的作用已得到广泛认可，但在理解经皮冠状动脉介入治疗（PCI）后PFT的预后意义方面，尤其是对于冠状动脉慢性完全闭塞（CTO），仍存在相当大的差距。
本研究调查了接受CTO-PCI患者的PFT与预后结果之间的关系。
一项回顾性研究分析了415例接受冠状动脉计算机断层扫描血管造影（CCTA）和冠状动脉造影（CAG）患者的数据。进行了PFT测量，并将患者分为正常组、PCI（非CTO）组和CTO-PCI组。根据生存状况评估CTO-PCI组内的预后意义。
各组间PFT测量值差异显著。CTO-PCI组在中位随访16.6±10.3个月期间的死亡率为13.9%。非生存组的平均PFT值更高（P=0.013）。ROC曲线分析确定平均PFT临界值为13.6 mm（AUC=0.682，P=0.011）。Cox回归分析将死亡率与左心室射血分数（HR=0.938，P=0.001）、白蛋白（HR=0.189，P=0.006）和平均PFT（HR=1.252，P=0.040）相关联。平均PFT升高与更高的死亡率相关（P=0.001）。
PFT是一种重要的炎症标志物，也是CTO-PCI术后一个有前景的预后指标。将PFT纳入风险预测模型可能会提高预后准确性，并有助于及时进行临床干预。
