Quantification of perivascular inflammation does not provide incremental prognostic value over myocardial perfusion imaging and calcium scoring
| Autor: | Catherine Gebhard, Geoffrey Warnock, Winandus J Wijnen, Alexander Meisel, Yves Pargaetzi, Christoph Gräni, Dominik C. Benz, Ahmed Haider, Susan Bengs, Aju P. Pazhenkottil, Elena Osto, Angela Portmann, Dominik Etter, Georgios Rampidis, Philipp A. Kaufmann, Ronny R. Buechel, Michael Fiechter, Valerie Treyer, Tobias A. Fuchs |
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| Přispěvatelé: | University of Zurich, Gebhard, Catherine |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Computed Tomography Angiography Short Communication Myocardial perfusion imaging (MPI) 610 Medicine & health Coronary Artery Disease 030204 cardiovascular system & hematology Coronary Angiography 03 medical and health sciences Myocardial perfusion imaging 0302 clinical medicine Predictive Value of Tests medicine.artery Internal medicine medicine Humans 2741 Radiology Nuclear Medicine and Imaging Radiology Nuclear Medicine and imaging Fat attenuation index (FAI) Aged 10038 Institute of Clinical Chemistry Inflammation Tomography Emission-Computed Single-Photon medicine.diagnostic_test Proportional hazards model business.industry Gender bias Myocardial Perfusion Imaging General Medicine 10181 Clinic for Nuclear Medicine 11359 Institute for Regenerative Medicine (IREM) Middle Aged Prognosis Coronary artery calcium scores (CACS) Log-rank test medicine.anatomical_structure Right coronary artery Cardiology 10209 Clinic for Cardiology Calcium business Electrocardiography 030217 neurology & neurosurgery Mace Emission computed tomography Artery |
| Zdroj: | European Journal of Nuclear Medicine and Molecular Imaging |
| Popis: | Aims Perivascular fat attenuation index (FAI) has emerged as a novel coronary computed tomography angiography (CCTA)–based biomarker predicting cardiovascular outcomes by capturing early coronary inflammation. It is currently unknown whether FAI adds prognostic value beyond that provided by single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) and CCTA findings including coronary artery calcium scoring (CACS). Methods and results A total of 492 patients (mean age 62.5 ± 10.8 years) underwent clinically indicated multimodality CCTA and electrocardiography (ECG)-gated 99mTc-tetrofosmin SPECT-MPI between May 2005 and December 2008 at our institution, and follow-up data on major adverse cardiovascular events (MACE) was obtained for 314 patients. FAI was obtained from CCTA images and was measured around the right coronary artery (FAI[RCA]), the left anterior descending artery (FAI[LAD]), and the left main coronary artery (FAI[LMCA]). During a median follow-up of 2.7 years, FAI[RCA] > − 70.1 was associated with an increased rate of MACE (log rank p = 0.049), while no such association was seen for FAI[LAD] or FAI[LMCA] (p = NS). A multivariate Cox regression model accounting for cardiovascular risk factors, CCTA and SPECT-MPI findings identified FAI[RCA] as an independent predictor of MACE (HR 2.733, 95% CI: 1.220–6.123, p = 0.015). However, FAI[RCA] was no longer a significant predictor of MACE after adding CACS (p = 0.279). A first-order interaction term consisting of sex and FAI[RCA] was significant in both models (HR 2.119, 95% CI: 1.218–3.686, p = 0.008; and HR 2.071, 95% CI: 1.111–3.861, p = 0.022). Conclusion FAI does not add incremental prognostic value beyond multimodality MPI/CCTA findings including CACS. The diagnostic value of FAI[RCA] is significantly biased by sex. |
| Databáze: | OpenAIRE |
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