Li Defu, Wang Yujin, Zhu Tingting
Department of Radiology, Fuyong People's Hospital of Shenzhen Baoan, Shenzhen.
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Comput Assist Tomogr. 2025;49(4):587-594. doi: 10.1097/RCT.0000000000001718. Epub 2025 Jan 27.
Vascular inflammation affects acute coronary syndrome (ACS) occurrence in patients with stable angina. Coronary inflammation can be represented by the pericoronary fat attenuation index (FAI).This study investigated the quantitative prognostic value of plaque characteristics and FAI in patients with stable angina.
Risk factors for ACS occurrence in patients with stable angina pectoris were retrospectively analyzed. The diagnostic value of FAI and plaque characteristics for ACS occurrence in these patients were determined; Kaplan-Meier curves were used to predict ACS event incidence.
After postpropensity score matching, data of 60 and 130 patients with and without ACS, respectively, were analyzed. Pericoronary FAI, lipid volume, and lipid percentage in the narrowest segment significantly improved ACS diagnosis in patients with stable angina. Luminal stenosis ≥50% and FAI >-88 Hounsfield units (HU) were independent risk factors for ACS occurrence in patients with stable angina. Perileft anterior descending artery (LAD) FAI >-88 HU better predicted ACS occurrence in patients with stable angina than did peri-LAD FAI ≤-88 HU.
In patients with stable angina, lipid volume and percentage and pericoronary FAI improved the diagnostic ability of luminal stenosis for ACS occurrence. Furthermore, peri-LAD FAI >-88 HU could predict ACS occurrence.
血管炎症影响稳定型心绞痛患者急性冠状动脉综合征（ACS）的发生。冠状动脉炎症可用冠状动脉周围脂肪衰减指数（FAI）来表示。本研究调查了斑块特征和FAI对稳定型心绞痛患者的定量预后价值。
回顾性分析稳定型心绞痛患者发生ACS的危险因素。确定FAI和斑块特征对这些患者发生ACS的诊断价值；采用Kaplan-Meier曲线预测ACS事件发生率。
在倾向评分匹配后，分别分析了60例和130例发生和未发生ACS的患者的数据。冠状动脉周围FAI、脂质体积和最窄节段的脂质百分比显著提高了稳定型心绞痛患者ACS的诊断率。管腔狭窄≥50%和FAI＞-88亨氏单位（HU）是稳定型心绞痛患者发生ACS的独立危险因素。左前降支（LAD）周围FAI＞-88 HU比LAD周围FAI≤-88 HU能更好地预测稳定型心绞痛患者发生ACS。
在稳定型心绞痛患者中，脂质体积、百分比和冠状动脉周围FAI提高了管腔狭窄对ACS发生的诊断能力。此外，LAD周围FAI＞-88 HU可预测ACS的发生。
