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Predictive value of pericoronary fat attenuation index for graft occlusion after coronary artery bypass grafting
Shuyuan Huang1,2, Xinxin Yu1, Baozhu Yang1,2
1Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong Province, China.
Insights
The fat attenuation index (FAI) of the right coronary artery (RCA) can predict graft occlusion after coronary artery bypass grafting (CABG). This imaging marker helps identify high-risk patients for early intervention and improved outcomes.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Cardiac Surgery
Background:
- Coronary artery bypass grafting (CABG) is a common procedure for coronary artery disease (CAD).
- Graft occlusion remains a significant complication, impacting long-term patient prognosis.
- Non-invasive imaging biomarkers are needed for early detection of graft failure.
Purpose of the Study:
- To evaluate the predictive value of pericoronary fat attenuation index (FAI) using coronary computed tomography angiography (CCTA).
- To assess FAI's ability to predict graft occlusion in patients post-CABG.
Main Methods:
- Retrospective analysis of 100 patients who underwent CCTA and CABG.
- Patients categorized into graft occlusion (n=27) and patency (n=73) groups based on follow-up CCTA.
- Measurement of FAI in the right coronary artery (RCA) and comparison between groups; Cox regression and ROC analysis performed.
Main Results:
- Higher RCA FAI was significantly associated with graft occlusion (P < 0.05).
- Multivariable analysis identified RCA FAI as an independent predictor of graft occlusion (HR=5.205, P=0.001).
- RCA FAI demonstrated incremental prognostic value beyond clinical characteristics (AUC 0.784 vs. 0.677).
Conclusions:
- Right coronary artery FAI is a valuable predictor of graft occlusion following CABG.
- This imaging marker allows for early identification of high-risk patients.
- Timely intervention based on RCA FAI can potentially improve patient outcomes.
Purpose:
Based on coronary computed tomography angiography (CCTA), this study aimed to evaluate the predictive value of pericoronary fat attenuation index (FAI) for graft occlusion in patients following coronary artery bypass grafting (CABG).
Materials And Methods:
The clinical and imaging data of 100 patients with coronary artery disease (CAD) who underwent CCTA and subsequently received successful CABG between December 2012 and March 2024 were retrospectively collected. According to the subsequent CCTA evaluation of grafts, they were categorized into occlusion group (n = 27) and patency group (n = 73). Based on CCTA images, FAI of the proximal segment of the three coronary arteries and epicardial adipose tissue (EAT) parameters were measured and compared between the two groups. The Cox regression model was employed to screen the independent predictors of graft occlusion. The predictive model was constructed, and the receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic performance of the model.
Results:
Among the 100 cases, 74 were males, with a mean age was 62.42 ± 7.57 years. During the 15.50 (5.00, 36.75) months follow-up period, grafting vessel occlusion occurred in 27 patients (27.0%). The right coronary artery (RCA) in occlusion group was -73.36 ± 7.24HU, which was notably higher compared to patency group (-79.93 ± 9.75HU) (P < 0.05). Multivariable Cox regression analysis indicated that RCA FAI (HR = 5.205, 95% CI 1.938-13.979; P = 0.001) was independently correlated with graft occlusion, with an optimal cutoff value of -79.39 HU.RCA FAI added incremental prognostic value beyond clinical characteristics for patients following CABG (AUC 0.784 vs. 0.677, P = 0.027).
Conclusions:
The RCA FAI can serve as a crucial predictor for graft occlusion in patients following CABG, enabling early identification of high-risk individuals and facilitating timely and effective intervention measures to enhance patient prognosis.
