Association Between Coronary Plaque Characteristics And CT-FFR Based On CCTA

Objective:To analyze the correlation of fractional flow reserve(CT-FFR)with coronary plaque characteristics derived from coronary CT angiography(CCTA).Methods:One hundred and fifty-three patients(195 vessels)in single institution who underwent CCTA were retrospectively included in this study.Quantitative coronary plaque features,including degree of stenosis,minimum lumen diameter(MLD),minimum lumen area(MLA),plaque length,total plaque volume(TPV),the volume of each component in plaque,plaque burden,adverse plaque characteristics and CT-FFR values were measured.CT-FFR≤0.8 was defined as lesion-specific myocardial ischemia.Results:Compared with CT-FFR>0.80 group(n=62),longer plaque length[16.20(10.90,23.95)vs 12.45(9.65,17.23)mm,P=0.004],smaller MLA[1.40(0.60,2.40)vs 3.80(2.58,5.55)mm~2,P=0.000],larger lipid plaques volume[16.85(7.35,38.95)vs 11.71(5.52,19.82)mm~3,P=0.029],and great plaque burden[70(63,77)vs 59(53,69)%,P=0.000]were found with significant difference in the CT-FFR≤0.80 group.The proportion of LAP and PR was higher[46.6%vs 30.6%;29.3%vs 16.1%,P<0.05]in CT-FFR≤0.80 group than that in CT-FFR>0.80group(n=133).Plaque length,plaque burden and LAP were independent risk factors for myocardial ischemia.Conclusion:Coronary plaque characteristics deriveded from CCTA are associated with CT-FFR.Plaque length,plaque burden and LAP are the main risk factors for abnormal CT-FFR.Objective To analyze the predictive value of fractional flow reserve(CT-FFR)and plaque characteristics derived from coronary CT angiography(CCTA)for major adverse cardiac events(MACE)in patients with coronary artery disease(CAD).Materials and Methods Eighty-eight patients with suspected CAD who had undergone CCTA and had follow-up data within 36 months were retrospectively included.The patients were divided into positive and negative MACE groups.Stenosis severity,CT-FFR and various plaque characteristics derived from CCTA were compared between both groups at per-vessel level.Discriminatory power of independent risk factors for predicting MACE was assessed.Receiver-operating characteristics curve(ROC)was used to evaluate the predictive value of these parameters for MACE.Results MACE-related lesions(n=17)had significantly higher values for the minimum lumen area(MLA),diameter stenosis,CT-FFR,total plaque volume,total vessel volume,non-calcified plaque volume,plaque length,plaque burden and low attenuation plaque(LAP)(p < 0.05)compared to the negative MACE lesions.In a multivariate analysis the following markers were predictors of MACE: CT-FFR,LAP,diameter stenosis,plaque burden,and plaque length.At ROC analysis,the combination of diameter stenosis,plaque characteristics and CT-FFR showed the most valuable prediction value for MACE(AUC: 0.821).Conclusions Combining CT-FFR,plaque length,plaque burden,and LAP shows incremental prediction power over CCTA diameter stenosis for MACE in CAD patients.