Prediction of acute myocardial infarction by multi-parameter coronary computed tomography angiography

• Published in: Clinical radiology Vol. 77; no. 6; pp. 458 - 465
• Main Authors: Wang, J., Chen, H.-W., Zhou, L.-J., Zhang, X.-P., Chen, B.-X., Chen, K.-D., Fang, X.-M.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.06.2022
• Subjects: Computed Tomography Angiography; Coronary Angiography; Coronary Artery Disease - diagnostic imaging; Coronary Stenosis; Coronary Vessels; Fractional Flow Reserve, Myocardial; Humans; Myocardial Infarction - diagnostic imaging; Predictive Value of Tests; Retrospective Studies
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2022.02.021

To investigate the performance of multi-parameter coronary computed tomography angiography (CCTA), including stenosis, plaque qualitative–quantitative characteristics, and fractional flow reserve derived from CCTA (FFRct), to predict acute myocardial infarction (AMI) and build a combined model. Thirty patients with AMI 90 days after CCTA and 120 matched patients without AMI were enrolled retrospectively. Multiple CCTA parameters were analysed and compared. Independent risk factors were obtained through univariate and multivariate regression analyses, after which a multi-parameter model was built. A total of 150 patients were analysed successfully. The multi-parameter CCTA model (area under the curve, 0.944; p<0.001) had a higher predictive value than each single parameter (p<0.001, all). Independent risk factors were intra-plaque dye penetration (IDP; odds ratio [OR], 8.373; p=0.002), lipid plaque volume (LPV; OR, 1.263; p<0.001), and FFRct ≤0.83 (OR, 8.092; p=0.001). This one-stop multi-parameter CCTA model, comprising IDP, LPV, and FFRct as independent risk factors, has good performance to predict AMI. •AMI can be efficiently predicted by our non-invasive CCTA model.•IDP has superior specificity and LAP has excellent sensitivity to predict AMI.•The optimal threshold of FFRct to predict AMI is ≤ 0.83.