Correlation Of CCTA-based Plaque Characteristics With The Degree Of Coronary Artery Stenosis And FFRCT

Objective:To analyze the relationship between CCTA-based plaque characteristics and the degree of coronary artery stenosis and FFRCT values.Methods:Clinical and imaging data of 198 patients with clinically suspected coronary artery disease from December 2021 to February 2023 were retrospectively collected from the hospital.All patients underwent CCTA examination after admission,and a total of 239 major epicardial coronary arteries were finally included.The acquired CCTA image data were transferred to a post-processing workstation for volume reproduction,surface reconstruction and maximum density projection post-processing.The processed data were transferred to the PACS reading system,and the raw data and processed images were visually evaluated by two physicians with more than 5 years of experience through a double-blind method.The nature of the plaque(including calcified plaque,mixed plaque,non-calcified plaque)and the characteristics of vulnerable plaque(including PR,LAP,SC)were evaluated.The vessels were divided into three groups according to the grading of coronary anatomical stenosis: mild stenosis group(1%-49%),moderate stenosis group(50%-69%),and severe stenosis group(70%-99%).The trend chi-square test was used to compare the differences in plaque nature and susceptibility of the three groups.FFRCT values at approximately 2 cm distal to the most stenotic lesion were measured using post-processing analysis software,and FFRCT ≤0.80 was defined as the diagnostic criterion for myocardial ischemia.The vessels were divided into FFRCT>0.80 and FFRCT ≤ 0.80 groups,and the differences in plaque nature and vulnerability between the two groups were analyzed by chi-square test,and the risk factors affecting FFRCT were analyzed by one-way logistic regression analysis and multi-factor logistic stepwise regression.Result:(1)The percentage of PR(P < 0.05),LAP(P < 0.05)and non-calcified plaques(P <0.05)gradually increased with increasing stenosis severity in the stenosis degree subgroup.(2)The proportion of PR(P < 0.05),LAP(P < 0.05)and severe stenosis of coronary artery(P< 0.001)were higher in the FFRCT≤0.80 group than in the FFRCT > 0.80 group;and PR(OR:1.96,95%CI:1.02-3.76)and severe stenosis(OR:4.31,95%CI:2.11-8.80)were independent risk factors for abnormal FFRCT.Conclusion:There is a correlation between PR,LAP and the degree of coronary artery stenosis and FFRCT values.PR and severe coronary artery stenosis are risk factors for abnormal FFRCT values.Accurate identification of plaque susceptibility characteristics can help in the early diagnosis of myocardial ischemia.