| [Purpose]To investigate the value of CCTA-FAI and peripheral blood related biochemical indicators in the assessment of residual inflammation risk after percutaneous coronary stent implantation.[Method]This retrospective study was reviewed and approved by the Ethics Committee of Shandong University Qilu Hospital,without requiring patients to sign informed consent.Part Ⅰ:A retrospective collection of 172 patients who underwent coronary stent implantation in Qilu Hospital of Shandong University from January 2015 to December 2020.Among them,86 cases had Grade 3 and/or(above)Adverse Events(classified according to Common Terminology Criteria for Adverse Events[CTCAE]:version 3.0),which were classified as severe adverse events.86 cases of adverse events below grade 2 were defined as the non-severe adverse event group.Routine laboratory examination results of peripheral blood(mainly peripheral immune cells and cholesterol related indexes)were collected before and one week after surgery,and the relationship between the results and postoperative residual risk was analyzed.Part Ⅱ:A retrospective collection of 89 patients(100 supports)with cardiovascular disease(CAD)who underwent coronary CTA before admission and after percutaneous coronary intervention(PCI)stenting between January 2015 and January 2019 was conducted.The perivascular fat attenuation index(FAI)values of the whole coronary artery(right coronary artery,left coronary artery,left coronary artery,coronary artery implanted with arterial stents),target lesion(TLs)and non-target lesion area(NTLs)were measured before and after PCI,and the differences were compared.At the same time,the changes of the relevant classical evaluation indexes such as plaque volume and type before and after operation in NTLs were compared.[Results]Part Ⅰ:In the severe adverse event group,all types of peripheral blood immune cells after stent implantation were greater than those before surgery,and only basophil granulocyte,basophil/lymphocyte,and eosinophil/lymphocyte had statistically significant differences(P<0.05);All types of peripheral blood immune cells in the severe adverse event group were higher than those in the non-severe adverse event group before stent implantation,but the difference was not statistically significant(P>0.05).Multivariate Logistics analysis showed that high density fat white cholesterol and HBA1c were related factors to predict severe adverse events after stent implantation(P<0.05),eosinophil/lymphocyte ratio had certain suggestive significance(P=0.097).Part Ⅱ:All 89 patients(mean age 61.65±9.85;The perivascular FAI values of all coronary arteries decreased after PCI,including 59 men with complete CCTA before and after stent implantation.On the contrary,the perivascular FAI value of NTLs increased after stent implantation(P=0.178).In addition,the volume of non-calcified,mixed and calcified plaques in NTLs increased after stent implantation,but there was no statistical difference(P>0.05).After PCI,lipid components,fiber-lipid components,volume of fiber components in mixed plaques and the total volume of lipid components in non-calcified plaques increased,with statistical significance(P<0.05).[Conclusion]Part Ⅰ:The peripheral blood immune cells of patients with coronary artery stent implantation were higher than the baseline level,and the similar subclinical changes may have certain implications for the management and treatment of patients with this type of coronary artery stent implantation.Part Ⅱ:The value of NTLs perivascular FAI can monitor the progress of perivascular plaques.As a promising new non-invasive imaging biomarker,FAI will help identify patients with coronary heart disease at high risk of inflammation and play an important role in long-term monitoring and guiding secondary prevention in this population. |
PDF Full Text Request