Predictive value of the perivascular fat attenuation index for MACE in young people suspected of CAD
Abstract Objective The perivascular fat attenuation index (FAI) evaluated by coronary computed tomographic angiography (CCTA) has been reported to have strong prognostic value, but few studies have focused on young people. This study aimed to assess the predictive value of the perivascular FAI in yo...
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BMC
2025-02-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-024-04401-0 |
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| author | Yani Yu Dongkai Shan Xi Wang Zinuan Liu Guanhua Dou Junjie Yang Yuqi Liu Yundai Chen |
| author_facet | Yani Yu Dongkai Shan Xi Wang Zinuan Liu Guanhua Dou Junjie Yang Yuqi Liu Yundai Chen |
| author_sort | Yani Yu |
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| description | Abstract Objective The perivascular fat attenuation index (FAI) evaluated by coronary computed tomographic angiography (CCTA) has been reported to have strong prognostic value, but few studies have focused on young people. This study aimed to assess the predictive value of the perivascular FAI in young people suspected of having coronary atherosclerotic disease (CAD). Method A retrospective analysis was performed on adults aged ≤ 45 years who underwent CCTA due to suspected CAD between 2015 and 2016 and who were followed up for at least 5 years following their visit (n = 503). The perivascular FAI at the proximal segment of the right coronary artery (RCA) was measured and grouped into high FAI and low FAI according to the optimal cut-off value, and the association between a high FAI and major adverse cardiac events (MACE) was evaluated by Cox hazard regression. K‒M survival analysis was conducted to assess the prognostic value of the perivascular FAI and improvement over traditional risk factor prediction methods. Results The event-free survival of patients in the high FAI group (FAI≥-75.2 HU) was significantly lower than that of patients in the low FAI group (FAI<-75.2 HU) at a median follow-up of 72.7 months (93.9% vs. 99.7%, P < 0.001). A high FAI (HR = 19.257, 95% CI: 2.504-148.107, P = 0.004) showed a significant correlation with an increased risk of MACE in young people. The prediction accuracy of MACE can be improved by including a high FAI on the basis of the traditional risk factor model, and the area under the curve (AUC) increased from 0.728 to 0.845 (P < 0.001). Moreover, the new model revealed significant improvements in integrated discrimination (IDI = 0.033, 95% CI: 0.009–0.103, P = 0.014) and the net reclassification index (NRI = 0.597, 95% CI: 0.000-0.699, P = 0.024). Conclusion The high perivascular FAI at the proximal segment of the RCA is significantly associated with an increased risk of long-term MACE and may be a potential tool for cardiovascular risk stratification in young people suspected of CAD. |
| format | Article |
| id | doaj-art-520de2df8240444da5edd3afd2d7f2bf |
| institution | Kabale University |
| issn | 1471-2261 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | BMC Cardiovascular Disorders |
| spelling | doaj-art-520de2df8240444da5edd3afd2d7f2bf2025-02-09T12:11:12ZengBMCBMC Cardiovascular Disorders1471-22612025-02-0125111010.1186/s12872-024-04401-0Predictive value of the perivascular fat attenuation index for MACE in young people suspected of CADYani Yu0Dongkai Shan1Xi Wang2Zinuan Liu3Guanhua Dou4Junjie Yang5Yuqi Liu6Yundai Chen7Department of Cardiology, The Sixth Medical Center, Chinese PLA General HospitalDepartment of Cardiology, The Sixth Medical Center, Chinese PLA General HospitalDepartment of Cardiology, The Sixth Medical Center, Chinese PLA General HospitalDepartment of Cardiology, The Sixth Medical Center, Chinese PLA General HospitalDepartment of Cardiology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General HospitalDepartment of Cardiology, The Sixth Medical Center, Chinese PLA General HospitalDepartment of Cardiology, The Sixth Medical Center, Chinese PLA General HospitalDepartment of Cardiology, The Sixth Medical Center, Chinese PLA General HospitalAbstract Objective The perivascular fat attenuation index (FAI) evaluated by coronary computed tomographic angiography (CCTA) has been reported to have strong prognostic value, but few studies have focused on young people. This study aimed to assess the predictive value of the perivascular FAI in young people suspected of having coronary atherosclerotic disease (CAD). Method A retrospective analysis was performed on adults aged ≤ 45 years who underwent CCTA due to suspected CAD between 2015 and 2016 and who were followed up for at least 5 years following their visit (n = 503). The perivascular FAI at the proximal segment of the right coronary artery (RCA) was measured and grouped into high FAI and low FAI according to the optimal cut-off value, and the association between a high FAI and major adverse cardiac events (MACE) was evaluated by Cox hazard regression. K‒M survival analysis was conducted to assess the prognostic value of the perivascular FAI and improvement over traditional risk factor prediction methods. Results The event-free survival of patients in the high FAI group (FAI≥-75.2 HU) was significantly lower than that of patients in the low FAI group (FAI<-75.2 HU) at a median follow-up of 72.7 months (93.9% vs. 99.7%, P < 0.001). A high FAI (HR = 19.257, 95% CI: 2.504-148.107, P = 0.004) showed a significant correlation with an increased risk of MACE in young people. The prediction accuracy of MACE can be improved by including a high FAI on the basis of the traditional risk factor model, and the area under the curve (AUC) increased from 0.728 to 0.845 (P < 0.001). Moreover, the new model revealed significant improvements in integrated discrimination (IDI = 0.033, 95% CI: 0.009–0.103, P = 0.014) and the net reclassification index (NRI = 0.597, 95% CI: 0.000-0.699, P = 0.024). Conclusion The high perivascular FAI at the proximal segment of the RCA is significantly associated with an increased risk of long-term MACE and may be a potential tool for cardiovascular risk stratification in young people suspected of CAD.https://doi.org/10.1186/s12872-024-04401-0Perivascular fat attenuation indexYoung peopleCoronary computed tomographic angiographyMajor adverse cardiac events |
| spellingShingle | Yani Yu Dongkai Shan Xi Wang Zinuan Liu Guanhua Dou Junjie Yang Yuqi Liu Yundai Chen Predictive value of the perivascular fat attenuation index for MACE in young people suspected of CAD BMC Cardiovascular Disorders Perivascular fat attenuation index Young people Coronary computed tomographic angiography Major adverse cardiac events |
| title | Predictive value of the perivascular fat attenuation index for MACE in young people suspected of CAD |
| title_full | Predictive value of the perivascular fat attenuation index for MACE in young people suspected of CAD |
| title_fullStr | Predictive value of the perivascular fat attenuation index for MACE in young people suspected of CAD |
| title_full_unstemmed | Predictive value of the perivascular fat attenuation index for MACE in young people suspected of CAD |
| title_short | Predictive value of the perivascular fat attenuation index for MACE in young people suspected of CAD |
| title_sort | predictive value of the perivascular fat attenuation index for mace in young people suspected of cad |
| topic | Perivascular fat attenuation index Young people Coronary computed tomographic angiography Major adverse cardiac events |
| url | https://doi.org/10.1186/s12872-024-04401-0 |
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