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Pericoronary fat attenuation index in computed tomography angiography is associated with mortality in end-stage renal

Nam-Jun Cho1, Bo Da Nam2, Samel Park1

  • 1Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea.

Kidney Research and Clinical Practice
|November 16, 2021
PubMed

Insights

Pericoronary fat attenuation index (FAI) measured at the left anterior descending artery predicts long-term mortality in end-stage renal disease (ESRD) patients. This finding may enable early intervention strategies for ESRD patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Radiology

Background:

  • Increased pericoronary fat attenuation index (FAI) on computed tomography angiography (CTA) correlates with higher mortality in the general population.
  • The predictive value of pericoronary FAI for long-term outcomes in chronic kidney disease (CKD) patients remains unestablished.

Purpose of the Study:

  • To evaluate the utility of CTA-derived pericoronary FAI in predicting mortality among CKD patients, including those with end-stage renal disease (ESRD).

Main Methods:

  • A retrospective longitudinal cohort study involving 268 CKD patients who underwent coronary CTA.
  • Pericoronary FAI was mapped and analyzed in three major proximal coronary arteries, with a focus on the left anterior descending (LAD) artery.
  • Multivariable Cox regression models were employed to assess the prognostic value of pericoronary FAI for long-term mortality.

Main Results:

  • Among 209 participants with LAD FAI measurements, pericoronary FAI at the LAD was not significantly associated with all-cause mortality risk across all CKD groups.
  • However, ESRD patients with elevated pericoronary FAI demonstrated a significantly higher adjusted risk of all-cause mortality compared to those with low FAI (HR, 2.26; 95% CI, 1.11-4.61).

Conclusions:

  • Pericoronary FAI measured at the LAD artery is a significant predictor of long-term mortality in ESRD patients.
  • This finding suggests pericoronary FAI could facilitate early primary interventions in ESRD patients.
Abstract

Keywords:
Chronic kidney diseaseCoronary inflammationEnd-stage renal diseaseMortality

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