Correlation Study Of Plaque Characteristics With FFRCT In Patients With Moderate Coronary Artery Stenosis

Objective:To analyze the correlation between plaque characteristics and fractional flow reserve based on coronary computed tomography angiography(FFRCT)in patients with moderate coronary artery stenosis lesions and to analyze the diagnostic value of plaque characteristics.Methods:A total of 381 patients(390 vessels in total)who underwent coronary CT angiography(CCTA)were diagnosed with moderate stenotic lesions(50%～70%)in the coronary arteries at Baoding NO.1 Central Hospital from January2017 to July 2022.The phase with the best CCTA image quality was selected and uploaded to the FFRCT software,and FFRCT values were measured manually.The FFRCT value was used as a threshold of 0.8,and the target vessels were divided into FFRCT≤0.8(75 cases)and FFRCT>0.8(315 cases)groups.The hemodynamic abnormalities were defined as FFRCT≤0.8,which means myocardial ischemia.To analyze the baseline data of patients and target vessels.To analyze the correlation between characteristic plaque parameters such as LAD,plaque location(proximal segment),high-risk plaque(HRP),lesion length(LL),the rate of maximum area stenosis,fibrous plaque volume,lipid plaque volume,non-calcified plaque volume,plaque burden(PB)and eccentricity index(EI)with FFRCT values in patients.Correlation of plaque characteristics with FFRCT values using Spearman correlation analysis.Binary logistic regression models were used to identify independent risk factors for FFRCT≤0.8 in patients with moderate coronary artery stenosis,and ROC curves were used to evaluate the diagnostic efficacy of multiple independent risk factors combined for FFRCT≤0.8.Results:1.To analyze the baseline information on patients and target vessels,including gender,age,BMI,diabetes,hypertension,hyperlipidemia,smoking history,family history,dominant coronary artery staging and location of the plaque.2.In moderate coronary stenosis lesions,the proportion of HRP was higher[16(21.33%)vs 38(12.06%),P=0.037];LL was longer [13.29(7.82,17.38)mm vs 9.97(6.84,13.69)mm,P=0.002];higher the rate of maximum area stenosis[63.72(56.98,6.49)% vs 57.46(53.83,63.53)%,P<0.001];larger lipid plaque volume[13.83(6.52,28.13)mm3 vs 10.34(5.27,16.62)mm3,P<0.001],PB was more significant [51.68(46.85,57.48)% vs 47.59(42.18,54.15)%,P<0.001]in the FFRCT≤0.8 group;All differences were statistically significant(P<0.05).3.Spearman correlation analysis of FFRCT values and plaque characteristics showed that FFRCT values were positively correlated with HRP,LL,the rate of maximum area stenosis,lipid plaque volume,and PB(P<0.05).Multifactorial logistic regression analysis showed that LL(OR 1.080,95%CI1.030～1.133,P=0.002),the rate of maximum area stenosis(OR 1.110,95%CI1.053～1.170,P<0.001),lipid plaque volume(OR 1.071,95%CI 1.039～1.104,P < 0.001)and PB(OR 1.063,95%CI 1.020 ～ 1.108,P=0.004)were independent risk factors for patients with FFRCT≤0.8(P<0.05).4.The results of the ROC curve showed that the combined model of four factors,LL,the rate of maximum area stenosis,lipid plaque volume,and PB,had the greatest AUC 0.826(95%CI: 0.772～0.880,P<0.001),sensitivity70.7%,and specificity 84.5% for the diagnostic value of FFRCT≤0.8(P<0.05).Conclusion:1.The diagnostic efficacy of HRP in patients with moderate coronary stenosis was less than that of quantitative plaque characteristics,and LL,the rate of maximum area stenosis,lipid plaque volume,and PB in quantitative plaque characteristics were independent risk factors for FFRCT≤0.8.2.A multifactorial regression model combining the above four independent risk factors has higher diagnostic efficacy in patients with moderate coronary artery stenosis with FFRCT≤0.8.