Relationship between prognosis of PCI and coronary CTA parameters in elderly patients with coronary chronic total occlusion
Tian Pengxiao
Zhang Yifeng
Wang Xinjie
Lyu Zhen
Mao Ning
Hu Guodong
Huang Zhaojie
Li Shuren
Abstract：Objective To investigate the relationship between the prognosis of percutaneous coronary intervention(PCI)and coronary computed tomography angiography(CTA)parameters in elderly patients with coronary chronic total occlusion(CTO),aiming to provide a reference for clinical treatment.Methods A total of 142 elderly CTO patients admitted to Xingtai Central Hospital from January 2022 to January 2024 were selected as research participants.General clinical data including age,sex,and body mass index(BMI)were collected.Coronary CTA parameters-pericoronary adipose tissue mean attenuation(PCATMA),pericoronary adipose tissue volume,and pericoronary fat attenuation index(FAI),were also collected.Spearman correlation analysis was used to examine the relationship between PCI prognosis and coronary CTA parameters in elderly CTO patients.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive efficacy of coronary CTA parameters for PCI prognosis.Results Among the 142 elderly CTO patients,25(17.61％)experienced major adverse cardiovascular events(MACE)and were assigned to the poor prognosis group;the remaining 117 patients(82.39％)without MACE to the good prognosis group.PCATMA was lower in the poor prognosis group than in the good prognosis group,while FAI was higher in the poor prognosis group than in the good prognosis group,with statistically significant differences(P＜0.05).No statistically significant difference was observed in pericoronary adipose tissue volume between the two groups(P＞0.05).Spearman correlation analysis showed that poor postoperative prognosis after PCI in elderly CTOpatients was negative-ly correlated with PCATMA(rs=-0.224,P=0.007)and positively correlated with FAI(rs=0.429,P＜0.001),but showed no significant correlation with pericoronary adipose tissue volume(rs=0.046,P=0.588).Multivariate logistic re-gression analysis revealed that PCATMA and FAI were independent influencing factors for postoperative prognosis in elderly CTO patients(P＜0.05).For predicting PCI prognosis in elderly CTO patients using coronary CTA parameters,the area un-der the curve(AUC)for PCATMA was 0.685(95％CI:0.602-0.761),with a sensitivity of 64.00％and specificity of 73.50％;the AUC for FAI was 0.826(95％CI:0.754-0.885),with a sensitivity of 68.00％and specificity of 83.76％;the combined AUC for PCATMA and FAI was 0.820(95％CI:0.747-0.879),with a specificity of 100.00％and sensitivity of 64.00％.Conclusion The prognosis of PCI in elderly CTO patients is negatively correlated with PCATMA and positively cor-related with FAI.FAI demonstrates good predictive efficacy for PCI prognosis in elderly CTO patients,and the combination of PCATMA and FAI promotes specificity.Detection results of coronary CTA parameters can serve as a reference for predicting and evaluating postoperative prognosis in elderly CTO patients undergoing PCI.
Keywords：Coronary chronic total occlusionPercutaneous coronary interventionCoronary computed tomography angiogra-phyPrognosis
Publication Date：2025-05-20
Online Publishing Date：2025-09-04(First online date of this platform, not the publication date of the document)
Pages：6( 44-49 )