Prognosis value of coronary CT-derived fractional flow reserve in diabetic patients with coronary artery disease
WU Shiyao
LIANG Quan
QIAO Hongyan
ZHOU Changsheng
ZHONG Jian
ZHANG Longjiang
CHEN Sui
YANG Guifen
Abstract：Objective To evaluate the prognostic value of CT—derived fractional flow reserve(CT-FFR)for predicting major adverse cardiovascular events(MACE)in diabetic patients with coronary artery disease(CAD).Methods A total of 876 CAD patients with coronary stenosis ranging from 25％to 80％,who underwent coronary CT angiography(CCTA)and had complete follow-up data,were prospectively enrolled.The median follow-up time was 2.9 years.Among them,224 were diabetic and 652 were non-diabetic.Baseline clinical data were recorded,coronary stenosis severity was quantitatively assessed on CCTA,and CT-derived fractional flow reserve(CT-FFR)were measured for hemodynamic assessment.The primary clinical endpoint was MACE,including all-cause death,non-fatal myocardial infarction,and unplanned revascularization.The survival probabilities of diabetic patients and non-diabetic patients were analyzed respectively by the Kaplan-Meier method,and the survival differences between the two groups with CT-FFR ≤0.80 and CT-FFR＞0.80 were compared by the log-rank test.Univariate and multivariate Cox regression analyses were performed to identify independent predictors of MACE in diabetic and non-diabetic CAD patients.Results Compared with the non-diabetic group,the diabetic group had higher rates of hypertension,more patients with coronary stenosis severity ≥50％,and higher levels of fasting blood glucose,systolic and diastolic blood pressure,and triglycerides;conversely,high-density lipoprotein,total bilirubin,and direct bilirubin levels were lower in the diabetic group(all P＜0.05).Kaplan-Meier curve analysis showed that in both diabetic and non-diabetic patients,the survival probability of CT-FFR ≤0.80 group was lower than CT-FFR＞0.80 group(both P＜0.05).Univariate and multivariate Cox regression analysis identified CT-FF R ≤0.80 as an independent predictor of MACE in diabetic patients,whereas hyperlipidemia,coronary stenosis severity ≥50％,and CT-FFR ≤0.80 were independent predictors of MACE in non-diabetic patients.Conclusion CT-FFR can predict the 3-year occurrence of MACE in diabetic patients with CAD.
Keywords：TomographyX-ray computedCoronary computed tomography angiographyCT-derived fractional flow reserveCoronary artery diseaseDiabetes
Publication Date：2025-09-15
Online Publishing Date：2025-10-13(First online date of this platform, not the publication date of the document)
Pages：6( 504-508,534 )