Correlation Analysis Of FAI And FFRCT With Degree Of Coronary Artery Stenosis In Patients With Zero Calcification

Objectives:(1)To investigate the diagnostic value of pericoronary fat attenuation index combined with CT noninvasive flow reserve fraction on the degree of coronary artery stenosis in patients with coronary artery disease with zero calcification score.(2)To analyze the plaque characteristics of severe stenosis in patients with coronary heart disease with zero calcification score.Materials and Methods: A total of 102 clinically confirmed patients with zero-calcification integral coronary artery disease at the First Affiliated Hospital of Dali University between January 2021 and January 2022 were included in this study with clinical and coronary CTA imaging data.There were 40(32males and 8 females)in the non-high stenosis group,aged(60.3±10.91)years,and 62(46 males and 16 females)in the high stenosis group,aged(58.6±10.16)years.Laboratory indicators and clinical data of all patients were collected.The time between the most recent laboratory examination and the imaging examination is not more than 10 days apart.The coronary CTA images of all patients were uploaded to the post-processing system platform(China,Sukun Technology),and the corresponding CT noninvasive blood flow reserve fraction,coronary fat attenuation index and patch-related parameters of the diseased vessels were measured.Two independent samples t test or rank sum test were used to compare the correlation indexes between the highly stenosis group and the non-highly stenosis group.(T-test of two independent samples was used to compare age,BMI,HDL-C,FAI,and pericoronary fat volume;TG,TC,LDL-C,CR,UA and FFRCT were compared by rank sum test).Univariate and multivariate Logistic regression were used to analyze the risk factors of severe coronary artery stenosis in CHD patients with zero calcification score,and the correlation between the risk factors and severe coronary artery stenosis was tested.The diagnostic efficacy of each index on the degree of coronary stenosis was compared by plotting ROC curves and obtaining the corresponding AUC values.P < 0.05 meant the difference was statistically significant.Results:(1)The proportion of hypertension patients,FAI value,lipid component volume,plaque length and plaque volume in the high coronary artery stenosis group were significantly higher than those in the non-high coronary artery stenosis group,and the FFRCT value was lower than that in the non-high coronary artery stenosis group,with statistical significance(P < 0.05).Other laboratory indicators such as TC,TG,LDL-C,HDL-C,CR,UA,etc,showed no statistical significance between the highly stenosis group and the non-highly stenosis group(P > 0.05).According to univariate and multivariate Logistic regression analysis,the independent risk factors of high coronary artery stenosis were hypertension,FAI and plaque lipid component volume.OR value of hypertension was 0.374,OR value of FAI was 1.119,and OR value of lipid component volume was 2.852.Pearson correlation test analysis showed that lipid component volume and FAI had the same and highest correlation with severe stenosis(r=0.454).(2)The AUC values corresponding to the diagnostic efficacy of FAI,FFRCT and their combination for severe stenosis with zero calcification integration were 0.795,0.737 and 0.84,respectively,and the AUC values were the highest when the combination of FAI and FFRCT.(3)The plaque length(18.46±9.28)mm,plaque volume 17.70(8.923,34.110)mm~3,and lipid component volume 4.86(1.215,8.065)mm~3 were significantly greater in the highly stenotic group than in the non-highly stenotic group with plaque length(5.78±3.66)mm and plaque volume 5.08(1,395,11.775)mm~3,lipid component volume 0.22(0.095,1.670)mm~3。Conclusion:(1)Hypertension,FAI and plaque lipid component volume are independent risk factors for severe stenosis in patients with zero calcification score.(2)Both FAI and FFRCT showed good diagnostic efficacy for severe coronary artery stenosis,and the diagnostic efficacy was significantly improved when they were combined.(3)Compared with the non-highly stenosis group,the highly stenosis group had longer plaque length,larger plaque volume,and larger lipid component volume.