Prognostic value of coronary computed tomography angiography derived parameters for major adverse cardiovascular events after percutaneous coronary intervention

LIU Xiao-cheng; LI Yong; LI Wei-tian

doi:10.3969/j.issn.1672-5301.2024.10.002

Abstract：Objective To explore the value of coronary CT angiography(CCTA)derived parameters in predicting the occurrence of major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI).Methods A total of 225 patients with acute ST elevation myocardial infarction(STEMI)who underwent PCI in our hospital from February 2021 to February 2023 were selected.After 12 months of follow-up performed in our hospital,the patients were divided into the MACE group(n=59)and the non-occurrence group(n=157)according to the occurrence of MACE.The differences of CCTA derived parameters[minimum lumen area(MLA),plaque load(PB),remodeling index(RI)and flow reserve fraction(FFR)]and clinical data between the two groups were compared.Logistic regression analysis was used to analyze the influencing factors of MACE after PCI.The predictive value of CCTA derived parameters to MACE after PCI was analyzed by drawing receiver operating characteristic curve(ROC).Results Among the 216 patients,59(27.31％)developed MACE.Compared with the non-MACE group,the PB level in the MACE group was increased,while the MLA and FFR levels were decreased(P＜0.05).There was no statistical significance in RI level between the two groups(P＞0.05).The proportion of family history of coronary heart disease,the proportion of multi-vessel disease and the number of implanted stents in MACE group were higher than those in non-MACE group(P＜0.05).Multivariate logistic model analysis showed that family history of coronary heart disease,multi-vessel disease,number of implanted stents ≥2 and high PB level were the independent risk factors for MACE after PCI(P＜0.05).High levels of MLA and FFR were the protective factors for MACE after PCI(P＜0.05).ROC results showed that the AUC(95％CI)of MACE after PCI predicted by MLA,PB and FFR alone and in combination were 0.681(0.615-0.743),0.708(0.642-0.767),0.736(0.672-0.793)and 0.880(0.829-0.920),respectively.The prediction efficiency of the combined test for MACE after PCI was better than that of each index alone(Z=4.034,3.602,3.521,P＜0.05).Conclusion In the patients after PCI,the increased PB level and the decreased MLA and FFR levels were the influencing factors for MACE.The combined index test has a higher predictive value for the occurrence of MACE after PCI.