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Bengs, S; Haider, A; Warnock, GI; Fiechter, M; Pargaetzi, Y; Rampidis, G; Etter, D; Wijnen, WJ; Portmann, A; Osto, E; Treyer, V; Benz, DC; Meisel, A; Fuchs, TA; Gräni, C; Buechel, RR; Kaufmann, PA; Pazhenkottil, AP; Gebhard, C.
Quantification of perivascular inflammation does not provide incremental prognostic value over myocardial perfusion imaging and calcium scoring.
Eur J Nucl Med Mol Imaging. 2021; 48(6):1806-1812 Doi: 10.1007/s00259-020-05106-0 [OPEN ACCESS]
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Co-Autor*innen der Med Uni Graz
Osto Elena
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Abstract:
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.
Find related publications in this database (using NLM MeSH Indexing)
Aged - administration & dosage
Calcium - administration & dosage
Computed Tomography Angiography - administration & dosage
Coronary Angiography - administration & dosage
Coronary Artery Disease - diagnostic imaging
Humans - administration & dosage
Inflammation - diagnostic imaging
Middle Aged - administration & dosage
Myocardial Perfusion Imaging - administration & dosage
Predictive Value of Tests - administration & dosage
Prognosis - administration & dosage
Tomography, Emission-Computed, Single-Photon - administration & dosage

Find related publications in this database (Keywords)
Fat attenuation index (FAI)
Myocardial perfusion imaging 
(MPI)
Coronary artery calcium scores (CACS)
Gender bias
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