Prognostic value of CT-derived myocardial blood flow, CT fractional flow reserve and high-risk plaque features for predicting major adverse cardiac events

• DOI: 10.21037/cdt-21-219
• Publication Date: 2021-08-10T09:55:42Z
• Authors: Lihua Yu; Zhigang Lu; Xu Dai; Chengxing Shen; Lei Zhang; Jiayin Zhang
• Keywords: Fractional Flow Reserve; Mace

Myocardial blood flow (MBF), CT fractional reserve (CT-FFR) and high-risk plaque (HRP) features have been revealed to be associated with patients' prognosis. However, direct intra-individual comparison of these CT-derived parameters has not explored yet. The aim this study was investigate the prognostic value MBF, CT-FFR HRP for predicting major adverse cardiac events (MACEs).Consecutive patients chest pain intermediate-to-high pre-test probability coronary artery disease (CAD) were prospectively enrolled. All referred dynamic myocardial perfusion imaging (CT-MPI) + angiography (CCTA) followed up at least 1 year. MBFischemic (mean MBF all ischemic segments), MBFratio (MBF segments/MBF reference measured multivariate analysis used evaluate predictive above MACEs.One hundred forty-two included into final analysis. significantly lower in MACE compared without (87 vs. 153 mL/100 mL/min 0.64 0.95, both P<0.001). Similarly, also markedly (0.58 0.88, P<0.001) whereas calcium score (CACS) higher (1,038.9 34.2, According ROC curve analysis, MBFischemic, CACS had largest area under (AUC =0.872, 0.855 0.813 respectively, identifying MACE. After adjusted by (hazard ratio =23.382, P=0.003) =3.759, P=0.029) independent predictors where failed value.MBFischemic derived from CT-MPI strongest predictor MACE, CACS. outperformed prediction unfavorable clinical outcome.