nach oben

Erschienen in:

15.01.2024 | Cardiac

Prediction value of pericoronary fat attenuation index for coronary in-stent restenosis

verfasst von: Zhong-Fei Lu, Wei-Hua Yin, U. Joseph Schoepf, Sameer Abrol, Jing-Wen Ma, Li Zhao, Xiao-Ming Su, Yun-Qiang An, Zhi-Cheng Xiao, Bin Lu

Erschienen in: European Radiology | Ausgabe 8/2024

Einloggen, um Zugang zu erhalten

Abstract

Objectives

As a novel imaging marker, pericoronary fat attenuation index (FAI) reflects the local coronary inflammation which is one of the major mechanisms for in-stent restenosis (ISR). We aimed to validate the ability of pericoronary FAI to predict ISR in patients undergoing percutaneous coronary intervention (PCI).

Materials and methods

Patients who underwent coronary CT angiography (CCTA) before PCI within 1 week between January 2017 and December 2019 at our hospital and had follow-up invasive coronary angiography (ICA) or CCTA were enrolled. Pericoronary FAI was measured at the site where stents would be placed. ISR was defined as ≥ 50% diameter stenosis at follow-up ICA or CCTA in the in-stent area. Multivariable analysis using mixed effects logistic regression models was performed to test the association between pericoronary FAI and ISR at lesion level.

Results

A total of 126 patients with 180 target lesions were included in the study. During 22.5 months of mean interval time from index PCI to follow-up ICA or CCTA, ISR occurred in 40 (22.2%, 40/180) stents. Pericoronary FAI was associated with a higher risk of ISR (adjusted OR = 1.12, p = 0.028). The optimum cutoff was − 69.6 HU. Integrating the dichotomous pericoronary FAI into current state of the art prediction model for ISR improved the prediction ability of the model significantly (△area under the curve = + 0.064; p = 0.001).

Conclusion

Pericoronary FAI around lesions with subsequent stent placement is independently associated with ISR and could improve the ability of current prediction model for ISR.

Clinical relevance statement

Pericoronary fat attenuation index can be used to identify the lesions with high risk for in-stent restenosis. These lesions may benefit from extra anti-inflammation treatment to avoid in-stent restenosis.

Key Points

• Pericoronary fat attenuation index reflects the local coronary inflammation.

• Pericoronary fat attenuation index around lesions with subsequent stents placement can predict in-stent restenosis.

• Pericoronary fat attenuation index can be used as a marker for future in-stent restenosis.

Graphical Abstract

Nur mit Berechtigung zugänglich

Windecker S, Serruys PW, Wandel S et al (2008) Biolimus-eluting stent with biodegradable polymer versus sirolimus-eluting stent with durable polymer for coronary revascularisation (LEADERS): a randomised non-inferiority trial. Lancet 372:1163–1173CrossRefPubMed

Dangas GD, Claessen BE, Caixeta A, Sanidas EA, Mintz GS, Mehran R (2010) In-stent restenosis in the drug-eluting stent era. J Am Coll Cardiol 56:1897–1907CrossRefPubMed

Moussa ID, Mohananey D, Saucedo J et al (2020) Trends and outcomes of restenosis after coronary stent implantation in the United States. J Am Coll Cardiol 76:1521–1531CrossRefPubMed

Niccoli G, Montone RA, Sabato V, Crea F (2018) Role of allergic inflammatory cells in coronary artery disease. Circulation 138:1736–1748CrossRefPubMed

Borovac JA, D’Amario D, Vergallo R et al (2019) Neoatherosclerosis after drug-eluting stent implantation: a novel clinical and therapeutic challenge. Eur Heart J Cardiovasc Pharmacother 5:105–116CrossRefPubMed

Shlofmitz E, Iantorno M, Waksman R (2019) Restenosis of drug-eluting stents: a new classification system based on disease mechanism to guide treatment and state-of-the-art review. Circ Cardiovasc Interv 12:e007023CrossRefPubMed

Yi M, Wu L, Ke X (2022) Prognostic value of high-sensitivity C-reactive protein in in-stent restenosis: a meta-analysis of clinical trials. J Cardiovasc Dev Dis 9:247

Yousuf O, Mohanty BD, Martin SS et al (2013) High-sensitivity C-reactive protein and cardiovascular disease: a resolute belief or an elusive link? J Am Coll Cardiol 62:397–408CrossRefPubMed

Antonopoulos AS, Margaritis M, Coutinho P et al (2015) Adiponectin as a link between type 2 diabetes and vascular NADPH oxidase activity in the human arterial wall: the regulatory role of perivascular adipose tissue. Diabetes 64:2207–2219CrossRefPubMed

10.

Margaritis M, Antonopoulos AS, Digby J et al (2013) Interactions between vascular wall and perivascular adipose tissue reveal novel roles for adiponectin in the regulation of endothelial nitric oxide synthase function in human vessels. Circulation 127:2209–2221CrossRefPubMed

11.

Antonopoulos AS, Sanna F, Sabharwal N et al (2017) Detecting human coronary inflammation by imaging perivascular fat. Sci Transl Med 9:eaal2658

12.

Oikonomou EK, Marwan M, Desai MY et al (2018) Non-invasive detection of coronary inflammation using computed tomography and prediction of residual cardiovascular risk (the CRISP CT study): a post-hoc analysis of prospective outcome data. Lancet 392:929–939CrossRefPubMedPubMedCentral

13.

Goeller M, Tamarappoo BK, Kwan AC et al (2019) Relationship between changes in pericoronary adipose tissue attenuation and coronary plaque burden quantified from coronary computed tomography angiography. Eur Heart J Cardiovasc Imaging 20:636–643CrossRefPubMedPubMedCentral

14.

Goeller M, Achenbach S, Cadet S et al (2018) Pericoronary adipose tissue computed tomography attenuation and high-risk plaque characteristics in acute coronary syndrome compared with stable coronary artery disease. JAMA Cardiol 3:858–863CrossRefPubMedPubMedCentral

15.

Oikonomou EK, Williams MC, Kotanidis CP et al (2019) A novel machine learning-derived radiotranscriptomic signature of perivascular fat improves cardiac risk prediction using coronary CT angiography. Eur Heart J 40:3529–3543CrossRefPubMedPubMedCentral

16.

Abbara S, Blanke P, Maroules CD et al (2016) SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: a report of the society of Cardiovascular Computed Tomography Guidelines Committee: Endorsed by the North American Society for Cardiovascular Imaging (NASCI). J Cardiovasc Comput Tomogr 10:435–449CrossRefPubMed

17.

Pan J, Lu Z, Zhang J, Li M, Wei M (2013) Angiographic patterns of in-stent restenosis classified by computed tomography in patients with drug-eluting stents: correlation with invasive coronary angiography. Eur Radiol 23:101–107CrossRefPubMed

18.

Li Y, Yu M, Li W, Lu Z, Wei M, Zhang J (2018) Third generation dual-source CT enables accurate diagnosis of coronary restenosis in all size stents with low radiation dose and preserved image quality. Eur Radiol 28:2647–2654CrossRefPubMed

19.

Min JK, Shaw LJ, Devereux RB et al (2007) Prognostic value of multidetector coronary computed tomographic angiography for prediction of all-cause mortality. J Am Coll Cardiol 50:1161–1170CrossRefPubMed

20.

Pencina MJ, D’Agostino RB, Pencina KM, Janssens AC, Greenland P (2012) Interpreting incremental value of markers added to risk prediction models. Am J Epidemiol 176:473–481CrossRefPubMedPubMedCentral

21.

Toutouzas K, Colombo A, Stefanadis C (2004) Inflammation and restenosis after percutaneous coronary interventions. Eur Heart J 25:1679–1687CrossRefPubMed

22.

Madjid M, Willerson JT, Casscells SW (2006) Intracoronary thermography for detection of high-risk vulnerable plaques. J Am Coll Cardiol 47:C80-85CrossRefPubMed

23.

Stefanadis C, Toutouzas K, Tsiamis E et al (2001) Increased local temperature in human coronary atherosclerotic plaques: an independent predictor of clinical outcome in patients undergoing a percutaneous coronary intervention. J Am Coll Cardiol 37:1277–1283CrossRefPubMed

24.

Gugliandolo E, Fusco R, Biundo F et al (2017) Palmitoylethanolamide and polydatin combination reduces inflammation and oxidative stress in vascular injury. Pharmacol Res 123:83–92CrossRefPubMed

25.

Wang R, Lu J, Yin J et al (2023) A TEMPOL and rapamycin loaded nanofiber-covered stent favors endothelialization and mitigates neointimal hyperplasia and local inflammation. Bioact Mater 19:666–677PubMed

26.

Park JH, Kim SW, Cha MJ et al (2018) TAK-733 inhibits inflammatory neointimal formation by suppressing proliferation, migration, and inflammation in vitro and in vivo. Exp Mol Med 50:1–12PubMedPubMedCentral

27.

Qiu H, Tu Q, Gao P et al (2021) Phenolic-amine chemistry mediated synergistic modification with polyphenols and thrombin inhibitor for combating the thrombosis and inflammation of cardiovascular stents. Biomaterials 269:120626CrossRefPubMed

28.

Ohyama K, Matsumoto Y, Takanami K et al (2018) Coronary adventitial and perivascular adipose tissue inflammation in patients with vasospastic angina. J Am Coll Cardiol 71:414–425CrossRefPubMed

29.

Antonopoulos AS, Antoniades C (2018) Perivascular fat attenuation index by computed tomography as a metric of coronary inflammation. J Am Coll Cardiol 71:2708–2709CrossRefPubMed

30.

Ridker PM (2016) A Test in Context: High-Sensitivity C-Reactive Protein. J Am Coll Cardiol 67:712–723CrossRefPubMed

31.

Kastrati A, Dibra A, Mehilli J et al (2006) Predictive factors of restenosis after coronary implantation of sirolimus- or paclitaxel-eluting stents. Circulation 113:2293–2300CrossRefPubMed

32.

Giustino G, Colombo A, Camaj A et al (2022) Coronary in-stent restenosis: JACC state-of-the-art review. J Am Coll Cardiol 80:348–372CrossRefPubMed

Titel: Prediction value of pericoronary fat attenuation index for coronary in-stent restenosis
verfasst von: Zhong-Fei Lu
Wei-Hua Yin
U. Joseph Schoepf
Sameer Abrol
Jing-Wen Ma
Li Zhao
Xiao-Ming Su
Yun-Qiang An
Zhi-Cheng Xiao
Bin Lu
Publikationsdatum: 15.01.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 8/2024
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-10527-0

Breast cancer: evaluating the axilla before, during, and after therapy—new challenges

Commentary

Automated MRI liver segmentation for anatomical segmentation, liver volumetry, and the extraction of radiomics

Open Access
Imaging Informatics and Artificial Intelligence

Choroid plexus enlargement in mild cognitive impairment on MRI: a large cohort study

Neuro

CT-guided core needle biopsies of head and neck tumors: a comprehensive monocenter analysis of safety and outcomes

Head and Neck

Current use and future perspectives of contrast-enhanced mammography (CEM): a survey by the European Society of Breast Imaging (EUSOBI)

Breast

Deep learning-based white matter lesion volume on CT is associated with outcome after acute ischemic stroke

Imaging Informatics and Artificial Intelligence

Neu im Fachgebiet Radiologie

Stumme Schlaganfälle − ein häufiger Nebenbefund im Kopf-CT?

12.01.2025
Computertomografie
Nachrichten

In 4% der in der Notfallambulanz initiierten zerebralen Bildgebung sind „alte“ Schlaganfälle zu erkennen. Gar nicht so selten handelt es sich laut einer aktuellen Studie dabei um unbemerkte Insulte. Bietet sich hier womöglich die Chance auf ein effektives opportunistisches Screening?

Die elektronische Patientenakte kommt: Das sollten Sie jetzt wissen

12.01.2025
Elektronische Patientenakte
Nachrichten

Am 15. Januar geht die „ePA für alle“ zunächst in den Modellregionen an den Start. Doch schon bald soll sie in allen Praxen zum Einsatz kommen. Was ist jetzt zu tun? Was müssen Sie wissen? Wir geben in einem FAQ Antworten auf 21 Fragen.

Stören weiße Wände und viel Licht die Bildqualitätskontrolle?

09.01.2025
Mammografie
Nachrichten

Wenn es darum geht, die technische Qualität eines Mammogramms zu beurteilen, könnten graue Wandfarbe und reduzierte Beleuchtung im Bildgebungsraum von Vorteil sein. Darauf deuten zumindest Ergebnisse einer kleinen Studie hin.

PMBCL mit CMR: Radiatio kann ohne Risiko weggelassen werden

08.01.2025
Non-Hodgkin-Lymphome
Nachrichten

Patienten mit primär mediastinalem B-Zell-Lymphom (PMBCL), die nach der Induktionstherapie eine komplette metabolische Remission (CMR) erreichen und keine konsolidierende Bestrahlung erhalten, müssen offenbar keine Überlebensnachteile fürchten.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Prediction value of pericoronary fat attenuation index for coronary in-stent restenosis